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HomeMy WebLinkAboutPlumbing Permit 15. 0283 E O )4 O . n O*0000 TS 0 > 22 D n a k kz 0 m ).§kkk m § 73 m §/ % r m § u) m CI)z k §2B - 0 2\ % t § z IQ ~ ■ - cn n Z § ,en 0 § ■ ::. � J% 11 0r z ■Mr o 3§ rn o X 17■ 00 ■� O 0000 M q 2m 3 .0 ® ■ � � o -4 z o o cn — m > m % \ ƒ m ` . xzxx z m 0 x ~ n § Vil r % co§ z § 0 q _ 0 z z x x z ¢ r z 7 co % /- 1317 P m 2 ik o X 73 m o n 0 g M 000000 _� q z ? IIS0M 3 K a. 1,1 V © xi 73 o c � � � � © ^ % i . ri > nn - A . t � � � r 2 � m -1 i 0 ' , . 1Rtp gOgi Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMITG4nvEso'� Blue Fik PERMIT NO.�5Z�'J? .cola c;ty 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) S4-/`I6 Woad 4.%- 1 19i, ©. L<lee LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) &�• L e( i�� (Phone) 9.52. 4/1/7- 7c>Z 3 (Address) 5 9 9 6 L ercoc1 4 a~n P/l o r L. .5 lc( , M/� 5313 7 2 _ ANT, (Na P/ '„-7 6 -is / G ec (Phone) G 5-"- ' z - /2 9"5"- (Addres 5—c- r�/1 , d--e-- _— (Addres Wit, (Zip Code s x'57- ((Contacte n) G C".07,.../ .9 ala r7/�Q;-� (Phone) APPLI T SIGNATURE DATE 9- APPLICANT -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 Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) (?.e�►ov�- I-C-.)1.- Laundry Tray(1 or 2 compartment sink Sewage Ejector a►„a ✓t/c.u..c e' Shower Stall Backflow Assembly lt..i 1 A 5hoci..toSinks 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 $ Building Permit# The Minnesota Statutes§3268,148 "SURCHARGE"has been extended PLUMBING PERMIT FEE $ The minimum surchar;;e for a STATE SURCHARGE $ 'fixed fee" permit is $5.00 TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid sz.lit Receipt N . 1 ep Date Af Building/Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372