HomeMy WebLinkAboutPlumbing Permit 14. 1104 E 00A n 000000 V 0 » 22
0 0 al T1 Ell 11 '71 z k
"84
§ n on *
MV° g8 m m
§ M � m m n
m m ■ E0 §> z a• -I-13
t •
13 2 ®§ Q P �§
10 al ■al 0 0 ■ cn n z 2 . § ■
1 \ 2c I.
( � m m
§ M 0 m
2 r Z 5� �, � .
1 -n -0 ►
I � � �
X
z X 7J
7) 0 0 O 0 O
X § m m 3 * ® r � '
§ EE ? & o o zm2mxm .0 0
% 2 m ; \ •
( � � � � xw m� \ r m
. o
q 2 0 2 1 r2 §/ Z C
§ z K m r � � P M
/ X73
§ 0 11 £.
c
a 2 . DOCOco
.. § X110 F.
0, mmo § � m
2 ; ® cmliv § .
\ / mmm
q m duIn ■ 1 2
- - m
-1 § B -
.c., 1-1,Rio Date Reed
-r
7, -,,''''.',t,„ CITY OF PRIOR LAKE PLUMBING PERMIT
''' .X 04, /q ,.
,,.,..„,...,
4747a.soo _
i.el= File 1
I E,
2.(told City RMIT NO. / i , r •
. /A) z-fl
3. Yellow Applicant iTe./
(pease type or print and sign at bottom)
ADDRESS ZONING tar ce use)
/773 VLA /74/22e))--) -Tr. SE - e1
•
LEGAL DESCRIPTION(office use only) ,‘
. ..
ziuyAlt/ ,
LOT S"BLOCK o., ADDITION ) ?Wea-
i-- PID 5-a9-it,05-k,c)
_.....
owNER , A
(Name) r t-a-42k- ,. eiL.f1)e.4)- (Phone)
(Address) 1 7 Z q 2- 1-4 112---0--tvm ) -r . ‘";E
APPLICANT
(Narne)_Fintii frm Ai --mf.,- ,,IQ, -)\Lurk,b)Yl'e.) '—L)//),41-\'6'ed (Phone) 1-:3 -1 --(01-te---;---(-6-.)32__
(Address '52_,(D- tEi
)
--,-.
(Address) (City) (Zip Code)
(Contact Person) w - - -effs (Phone) . L: 1
LI. ,, .in___,
APPLICANT SIGNATURE K DA PE
- • Ica( 2 (1
APPLICANT PLEASE COMPLETE BELOW
Quantity ' Type of Fixture Quantity Type of Fixture
Bath'rub with or without shower Rough-ins
Dishwasher Water Heater
.. .
Floor Drain I Water Softener
Lavatory(Bathroom Sink) — Stand Pipe WasiLIjj[1-,1s.14chine)
---
1 Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assemb_ly_
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
____
Water Closet(Toilet) Other
— ------ ..
FEE SCHEDULE
Industrial.Commercial&Multi-)umily 1%of job cost with a$49.50 minimum Residential.New One&Two-Family S149.50
Residential,Additions&Alterations $49.50
The Minnesota Statutes§32611.145 tst $ Building Permit ft
"SUM IAR.61';"has been changed for one (A lt
year effective PLUMBING PERMIT FEE $ ' .6 1.1'''./ _
.1:ii, ;.20i0.until,Itine 30,201 i. STATE SURCHARGE $ \, _.50
I hn"
e minimum surcharge for a"fixed fee"permit TOTAL PERMIT FEE $ , U
i% 5.,beginning July 1,2010
This Application Becomes Your Building Permit When Approved ICV . IF Receipt No.
,_
:i,.;---- r-\-- By
Buntline Official Date \\) ' 0 '
_,)--
24 hour notice for an inspections(952)447-9R50„fait(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372