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Plumbing Permit 15. 0937
J O O n O�OCOO i g � � n n 7 O 0 . q , �kkk z m k rn/ k r k N x rn zr; § § 2 Z $ �13 ` i � › § z m 0 — 272 » z o z , .• 9 n -n .. -, z r• o \ N z § z 4 § A o 0 > © H X F § % � -Ti % m 2 0 0 (. _ EL 000000 hi 2 m § � as e- / sTI ■ * ■ l 2 -4 § o o �� 2i § � 2c § -o f 0 EZ7dmZ 23 z X ". E m ] > 000 0 s -I p § g q U 0 rz22 • C § 2 4 § , 11-* 'a .° P o i7 m 2 0 t A OO0000 § E § vin W 4 :i� § Rs ■ mm ■ o q _ Z P OC) m - n2 & _ 9 rn , ' � � 73 2 § r § m lc r 4441174P''' 4p7 Date Re ''' CITY OF PRIOR LAKE PLUMBING PERMIT' e _ 13edIS 4-,*AtES°�� D..Cidlue File t: i e. PERMIT NO. 9 8.49llaw i licent `l /p mpint and sign abates.) ADDRESS/ ZONING ki 932I/ G� f oar C�v7�r-� k LEGAL DESCRIPTION War use LOT BLOCK ADDITION PID OWNER (Name) c. LLOLrY -S-'f rvA.J ) ,<'/a 7 3 >3/g 9 I (Add ) ,S c-,_,ti. APPLICANT i (Name) /9 ' (Addams) /V.5�-.4")-- �,LiAe A, ClAcks/-0. S' 3 ig ( (City) ,.._,:---4. � (Zip Code) (Co t Peen) ,C . , 7,� (Phone) S. 2 --1 7 v y 53 / APPLICANT SIGNATURE ,�'. . A DATE 7 // APPLICANT PLEASE COMPLETE BELOW Qmudity ! Type of Fixture Quantity ' Type of F' ' Bath Tub with or without shower Dishwasher Rough-ins Water Heater t Floor Drain " i Water Softener 4 Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) • Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall t ; Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn r Water Closet(Toilet) Sprinkler {/P(/� 0,t.)/�J er FEE SCHEDULE Commercial&1,4 ' faraily 1%of jolt host with a$49..50 Res" Now One&Ts" $449.50 Resiclentil,Additions L i &Alieiatio®s $4930 Estimated Cost $ 7 CD-O Building emit PLUMBING PERMIT FEE S STATE SURCHARGE $ SII-r r TOTAL PERMIT FEE $ S v S (Office Use ally) This Appy Becomes Y�Buildi Permit'When Approved Paid J`� I Receipt No { i 1 Date By)O3., IC ' By) 24 low swum tor al iaspectiOas(952)447-9850 64.-d- 44416 Dakota Street SSS.,Prier[wire,Mieseeeta 55372