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HomeMy WebLinkAboutPlumbing Permit 13. 0208 0 O n 000000 7 0> 2 B k 0 00 0 § I K J 0O 0 m 9 m 0 0 / r \ m m 0 k q c§ cn z� k Co -- m r § § ■ 2 § ®® - ® ' Z w m o o 2 0 ttl to § _§ 0 J §§ r) z \ K 6 9 A / 0 > z X \ § \ Cr m 2 00 (..f 000000 m §mm �� ®* © r 0 x mm Mr > § § �� � ■ �i§ 0 t 0 k g 0 z §§§ - K § z m zi k 0§ 0 r In oo @ w@ 0 7 \ 2 " Ic§ m z K m r �� 0 m / 1 m § m W (2?) m �_ Xo0000 | § z 2 3�1I » § R. 0 m m 0 k K�� ; § D \ 0 »qrn�> ® n a _■ � r -1 § m w Z - i ■ | -t> 0 04 p R10 � Date Rec'd N CITY OF PRIOR LAKE PLUMBING PERMIT 311-2)k,_ �j 4 "'.se I. Blue File PERMIT NO . 2. Gold City 3 1 3. Yellow Applicant • c/ (Please type or print and sign at bottom) ADDRESS , (office use) X571 Humry.,4 i re Tr T / 1 ; , LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION <7j o 14 , 3 R r A-- b b N PID 15 ?f 4S- 06 6 OWNER i. ' ' 1 p (Name) C dAGkwci eSh (Phone) ��z / ��� �� �J (Address) LI 5 1 1 tui V'1� (� 1'Jt ral Tr Ne' APPLICANT Appliance Connections Inc. (Name) 12850 Chestnut Blvd. (Phone) (Address) Shakopee, MN 55379 A52445 -4803 (City) (Zip Code) (Contact Person) 5M \ I -"Pe 1 in (Phone) APPLICANT SIGNATURE C1,'LL DATE . Z APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins Dishwasher 1 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 I% of job cost with a $49.50 minimum Residential, New One & Two- Family $149.50 Residential, Additions & Alterations $49.50 %(7 . tn Estimated Cost $ ' &- Building Permit # PLUMBING PERMIT FEE $ c 4. 00 STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ 74. 5 (Office Use Only) This Application Becomes Your Building Permit When Approved `a i 6 5 o Receipt No. • CC�a / • r Dat 1-- By • 4 Bu Official Date i i / , W . , / 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 Dn anoitosnoo3 e3nsiiqqA bvI8 tuntes110 onst Ofiyi ,seqopesde co8vaw-see