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HomeMy WebLinkAboutPlg Permit 01-0512 Quantity CII V OF PRIOR LAKE C PLUMBING PERMIT Applicant: 5 --trCt< J Wo)-cr Cb-r.d,' h~B Address: 1:2 ?!,j1 fVI / n ,::::L~ )I J /CU~ '.-0-(' '. 'I/-f) .0 . Signature: ~~ tit -/)"' ~ K.ptl /' v '. . ' Legal Description: Lot l f.. Block f Sub: Site Address:_1 7 :J-Ll...,9( ~b IJLI; :., Y (fl ,_ Building Permit # PID #/::{ .:; NOTE: This permit will not be processed without complete information. FIXTURE UNITS 1'1 1. Blue 2, Gold 3. Yellow # ~t- q File City Applicant Type of Fixture Unit Amount 3 7:A. OUL/ - 0 Bath Tub with or without shower Dishwasher Floor Drain Lavatory (bathroom sink) Laundry Tray (1 or 2 compartment sink) Shower Stall Sinks: Bar Sink Water Closet (toilet) Rough-ins Water Heater Water Softner Stand Pipe (washing machine) Sewage Ejector Backflow Assembly (RPZ, Double Check, PVB) Backflow Assembly Test Lawn Sprinkler Other $ 6.00 $ 6.00 . $ 6.0 $ $ 6.00 $ 6.00 $ 6.00 $ 6.00 $ 6.00 $25.00 $10.00 $25.00 $ 6.00 $25.00 SURCHARGE Minimum Fee GRAND TOTAL $ '~Gj. 6U .50 'If) (]) This permit is granted upon the express condition that said contractor, shall comply in all respects with the ordinances of the State PI~bing Code and ~~e~d'Pents thereof. 3.9-h Lj. RECEWfNu..r>:.q/ (j / DATE rr./ AITEST Call for all inspections 24 ho~ i~ advance. 4629 Dakota St. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245 AN EQUAL OPPORTUNITY EMPLOYER