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HomeMy WebLinkAboutPlumbing Permit 16. 0174 05 >c � 0 000000 ;13 0 > E0 n 0 a © 0 o . z © § o 0 ■ ■ 73 ■ ■Vo8 Z m ■ * r. 9 m CO m Z � \ � � z Ill xp k -I 13-7/ / 1. 2 o� Q . Z- q ■) q 0 cn 0 z z § Z ■ 7 z § m 1 § § \ 0 / > 2 m m 73cA x r o 3 L m o 73 ■ Z 73 R R �— 000000 \ - mm `� m "0m > rr ■ ■ Fill, . ncimx 2 ? 7 $ § 2 0 ► 3 § ■ § 73 § m 0 '- 0 " )5 m 0 zzzz - a ■ z z tri -I S 0 r"I§o 73 z p 0 0 m .� § o • 0 V. 0 a ° il X 73 0 m D0DE Aill p, Kkki§ ' t" N ,- a _ -a -a � 73 01 0 7 > 00\ qm � 33 r _ U � Z m -Ir o of PRI0�PC Date Rec'd 9 CITY OF PRIOR LAKE PLUMBING PERMIT r*NES° I.Blue File 2.GoldPERMIT NO./6 O/7y App 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ••- - ZONING(office use) yo 3u ockvail SV S ; I J) LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION r/`7f Jf®e / L PID z..5--..ow 003 - OWNE((Name) Cyç Q 'v`S.Vja ■ /j) (Phone)°to_2-_339 NA) (Address) 43Lf v\o Q c '� S y, N APPLIC' l It t ,-rr yy u (Name) WI \ IC.` . £ \ 1 _. 1k. Lu_ '.. 1.r (Phone) 5.A•\`-[�_���� (Address) v $ A ��i # 11 •`. (Address) (City) (Zip Code) _ (Contact Person) t....♦VI.CJ.L.1,, _— (Phone) C.k,W..--&_ APPLICANT SIGNATU• IIKIIVIIIIN_ _ _._� ` A c.1.�.�it.\ k, D,,TE i 40 io APPLICAN LEASE COMPLETE BELOW Quantity _ Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher yWater 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 $ 16 l7•6 !-- Building Permit# PLUMBING PERMIT FEE $ 4q V STATE SURCHARGE $ ,1,$1.00 TOTAL PERMIT FEE $ 60 d (Office Use Only) This Application Becomes Your Building Permit When Approved Paid,4 50 Receipt No. Vi/6.2...„Date /_ By f Building Official Date ? / . /I& S3....._ 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372