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HomeMy WebLinkAboutPlumbing Permit 14. 0798 J 0O n 010 Ooc 4 0 I ■ n 2 * O ■ § -n � � § § q so§ § o . s 4 ® c § m m n0 k 2 �rk§ § - § §\ * r • n ■ 2 Q� Q 0_ § , \ 119 0 9 § 73 _ 0 § � � j m\ § 2 r z 3 il § 2 'V '511 C z 2 § § v ❑ oOOO 0 -4 § 0 0 . mrm $ mr -4 M ■ ( 0 -IOC `_ ■§ m ■ § m 0 CD . I - ! zzxx - E0 3 q $ 2 •E g j � r � § § c q 0 o z cc pre 2 r m � 1:1 '0 X § m �?ii M] cOOOOQ ! _ 0 MI72 §k 0 , q k z41 gi � 5 5 5E A a © © &q _ ■ 2 -t - E m -Ir o 04AID�i 1 • Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT •- F.: 6' /c/ 7.Galaeold FiCittey PERM0.IT , fy`1 I 3.Yellow Applkent , 1 7 (Please type or print and sign at bottom) _ ADDRESS r ,p ZONING(arta use) 1 9R i I/ LEGAL DESCRIPTION(office use only) _/// -` LOT K'BLOCK I ADDITION.]WC:e:. � W / f--.Q LOpH} 71 -OIC— OWNER C�Ar / (Name) 1 f1( ,J &54J-7 (Phone) 9Y.)--,241- tp -7‘f '. (Address) /'7r .. O I r ' APPLICANT,— (Name) J 21 r- (Name) Pt hOGic Con.. . (Phone) 3.2r—J-1 - -)9' J—/J 8 1_ - (Address) ,__- __.__Qx r/3eJ 3d4�t. dl�6/(Ads) (City) (Zip Code) (Contact Person) ,17)Y2 I 4,.47.--6E- _ (Phone) J.- P-J-7? -.-- 9-17 APPLICANT SIGNATURE J J)— DATE *7— 3'1-/y 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 l Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) __-_- ---- Laundry Tray(I or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Tes Bar Sink Lawn Sprinkler Water Closet(Toilet) Other The Minnesota Statutes§326.44i3-- ori cost with$EE 0 mHEDULE Residential,New One& $149.50 "SGRC iARGB"has been extended • IfTwo-Family Residential,Additions&Alterations $49.50 The tttiuimtun surcharge for-1 "fixed fee"permit is$5.00 $.____.. Building Permit# PLUMBING PERMIT FEE $ qi-SO STATE SURCHARGE $ LIM 5.00 i TOTAL PERMIT FEE $ SY.41 Lt (Office Use Only) �� • f This Application Becomes Your Building Permit When Approved 'Ili' ' -5-tt- i o. l,q 2- Official —- -- Building Date By �'j Date �,j= •—( 14_ _-------- ! ___ 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.G.,Prior Lake,Minnesota 55372