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HomeMy WebLinkAboutPlumbing Permit 16. 0129 c n O ❑ ❑ 000 13 0 a § n 000 s § �co � 8 z m x ITI �4 to r n X/ 73 X s ni z §i- EZ § 1. 0 -Im t t § § > rn Z -40 § § P �k 0 ■ ■43 © z § §„ n 11 0 > \ Z - 0X % r z CI 5-%,� ro f 1:1 % 2 0 0 § O ❑ O ❑ OO N X m m m -0Cn § m "0 � a § k § mxil m § it. 0 lo ■ ? m Cir. C o - IP r -n 0 §_ B p oi 0 N n ° § 2 : m / r 12 � p m r % o / � 0 0 ■ 0 00000 ■_ m . o q > § > 2730 ` ■ § ✓ © q G CATTI ® - . M �N Z - A ® ■ nnt � -1 § m ' - �Q § ■ l_ r § 01 PR/04) Date Rec'd ,AN CITY OF PRIOR LAKE PLUMBING PERMIT z, zz J6 1. Blue File 3 cold City PERMIT NO.//_ o/� 3. trei Applicant (6 (Please type or print and sign at bottom) ADDRESS ZONING(office use) IIngQ( Monror I ie SW R/5,_—A. LEGAL DESCRIPTION(office use only) LOT 7BLOCK ADDITION 3/ 5/1//1 211- 7- PID 25- l 3 3-e (NawmeE r av 1 4 a)ery I .Sieh ride/ (Phone) 7 - LAI 7 - 3.3/ (Address) )LQgq / " Ionroc Ave , \AJ RI or- La.Ke, +" 1 iv s573 APPLIC� 1 A I/� /��,,,, (Name) l K 1 n UVl1 1' eon, (Phone) Spa) - 5 g0- 0 75O (Address) L QX (Q5 l-)u rcHiN& /, Al Al 55350 (Address) (City) (Zip Code) (Contact Person) Iit rl -i-L3Jc)- roy� (Phone) ���� �` /50 APPLICANT SIGNATURE/. �"- •- DATE C /9-/(-0 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater Floor Drain / Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet(Toilet) Other FEE SCHEDULE Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $49.50 Estimated Cost $ Building Permit# PLUMBING PERMIT FEE $ LP 50 STATE SURCHARGE $ $1.00 TOTAL PERMIT FEE $ 0 . .5O (Office Use Only) This Application Becomes Your Building Permit When Approved Paid 56 \-0 Receipt No. 4t3 Date 22 // By 5 Buildin¢Official Date w, ( (� 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372