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Plumbing Permit 14. 0718
o _ -QI W Z Z CI) CX LL E F WW4 V W s 23552 Z 0000 ❑ ❑ W 7 0 rt 0 re 0 LL C W O » < I CO c O _ _ Z 0 W m \ ` Z Z O ' Ce t OC Og " -I 0 0 di W k 0 ( 0 W za ZLL w Cl, c N 0 1 0 d 2XWWXX d 0 z 0WQ6n0 0 0 2 i- O a23wa2 W W W L. O. a LL i` � 1Y 0 J rti- W W �� 0 Z V O YV V _ Z v 0 0 Q O z go ti HO Z ° N y V 0 r 01 OZ 0 W F- i= Q ao N O z0E5 17. z W W W W 0 W co W W 00 <<ILI 0 K CI V V n o o u. u.. 3 v v 1. 0 a 0 a 0000❑ C.) 1114 0 E 4 PRI0 - Date Rec'd :4.4)1 7 Z.-CITY OF PRIOR LAKE PLUMBING PERMIT -. Z I 4-- 1/[ 6-141/t4-- , 1—<f-- :8Otd Fi1a PERMIT NO. /4-, 714e 2 Gold Gtity 3.Yeltow Applicant C (Please type or print and sign at bottom) ADDRESS ,, ZONING(ofrtce use) i1 Fork kl,cDI1e.4 Ave-SUl+eDs LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID (Name) 4 ..rJ, l 4 / l-l^-L �� ��t!//2'Li-) ,2(Phone) — (Address) APPLICANT L p {\ n n, (Name) 6f i > int-C4) N i C.Ps I Co ig-(Phone) !s z --'3, -X 0 9 (Address) 2--0 "I' 4 St N Y IfV Neo) �( f1 v ©71 _ ` (Address) (City) L) (Zip Code) (Contact Person) !� -� ! S-t t`I c (Phone) q5 z ---14S-86 9 5 _ APPLICANT SIGNATURE -_ ....7'7----1__ /tel`2'j--e—ii//10--6- DATE 7! 22-1P+ — U 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) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall _ Backflow Assembly I _Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet(Toilet) Other FE SCHEDULE The Minnesota Statutes§326B.148 job cost with$49.50 minimum Residential,New One&Two Family $149.50 "SURCHARGE"has been extended - Residential,Additions&Alterations $49.50 The nliflinluin surcharge for a "fixed fee"permit is$5.00 $ Building Perm 'itt# .PLUMBING PERMIT FEE $ i- q. 60 STATE SURCHARGE $ XXX 5.00 TOTAL PERMIT FEE $ `r 1 ,, 'co (Office Use Only) • This App io4ecomex Your Building Per ' t Whe Approved Paid Rece' No. Pw Z3 Date B 'din•Official Date i� 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 RNT O PRIOR LAKE BUILDEPADINGTMEAND INF SPECTIION INSPECT RECORD SITE ADDRESS ! T " s NATURE OF WORK /� USE OF BUILDING PERMIT NO. ISSUED CONTRACTOR . PHONE G/ Z. �1, "2.4 Z. INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES INSPECTOR DATE rill=1814111.1.11.111W PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS FRAMING INSULATION :`1� 1 l ELECTRICAL PLUMBING \fie '-] zti f HEATING tom` '� S 4111.111111111gligft WORK UNTIL THE ABOVE HAS BEEN SIGNED MO 11 FINALS BUILDING r, t 1 ' Aa, tU z3 cy ELECTRICAL PLUMBING 7 3i i4 HEATING Si DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGN D NOTICE This card must be posted near an electrical service cabinet prior to rough-in inspections alnd maintained until all inspections have been approved. On buildings and additions where no service cabinet is available, card shall be placed near main entrance. FOR ALL INSPECTIONS (952) 447-9850