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Home My WebLink AboutPlumbing Permit 14.023 J 0 • 0 000000 "a 0 > 2n n n J 0 © 0 . M �z Ez° m c O 0 z m � 4 O r o ZZ X s r ■ om © r m m ■ § 0 ■ � ■ hi A . �j -I m 0� 30 � 0 k 01 n , . 0 % q >0 Mm % 0 r r 0 3 k 0 0 ` I 000000 X grnm �� ■sue en � \ ? § oo %� ■�� m 0 tO / 2 m G \ >Ogo 0§ m r - § 0 73 4 p o • m 4 j /cc Z � ` m z R m 0 / A q m • a §OOOO ( § § >xiz0 � ttl o < z � -0 / xi -x•m 4 m m " ■ 2 1a z m -1 r 0 - s,, . s . '1,•T'^.' . ',., - ',W15,?.,-,..7.U., :n,, 7 -yam =t 04 V Rta � Date Rec'd Aiii, CITY OF PRIOR LAKE PLUMBING PERMIT v o�' iS I. Blue File PERMIT NO 2. Gold City NO. / 3. Yellow Applicant lease or print and sign at bottom) ADDRESS ZONING (office use) 8L/ 7 I,0i () L r1 14) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (Nam OWNER I l I L l ■, (Phone) �01 '� l - qo ks (Address) ....______---_______ 9441,...e....... APPLICANT Ap Connections estnu Inc. (Name)._ IianeP (Phone) (Address) 1 Ch FBI (A d op , ee MN 5 5379 %52, (City) (Zip Code) (Contact Person) _ ,/ I I ' ∎ 4 e ' (Phone) 2 APPLICANT SIGNATURE .a� %/Ill. I _ i._ / DATE `d / 3J DI3 P r 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 The Minnesota Statutes § 326B.148 FEE SCHEDULE "SURCHARGE" has been extended fjob cost with a $49.50 minimum Residential, New One & Two - Family $149.50 Residential, Additions & Alterations $49.50 The minimum surcharge for a "fixed fee" permit is $5.00 $ Building Permit # OM PLUBING PERMIT FEE $ , M . STATE SURCHARGE $ in__ f✓8 TOTAL PERMIT FEE $ 4.■ Aim_ (Office Use Only) r te• • i This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Buiidine Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 . . .