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HomeMy WebLinkAboutPlumbing Permit 15. 1250 di 5 0 ONts, n 000000 -0 0 > ■ n 54 n n § § o . 0 22K$ 0§ 0 x k r 0 0 (A m z � > § oz Cl)m xi �� m m ■ o § t q - z 1, §© § Q P Zk q e 0 � Cl) q Z g Z ■ b ■ � » §z d � b § > > ( m m 73 m xioo f-41 m m m ■ '0 ■ * ■ 'a E cn 0c § -40C § 0 m 0 m . . § x m ■ s o ■ n � - © \ m ' -9 > c 0 0 k 73 - m q q o Z r2 §2 z p § ?!- 2 R. m r "0TI P m / ab 0 I73 . : c o N m X000 ❑ 0 k `z @ 0 om > §0 § .v0 m hi • kk � 9 § XI -n e - _ -IE � i z r C✓ 04 PRXp� Date Rec'd Ev• ` CITY OF PRIOR LAKE PLUMBING PERMIT amea File PERMIT NO/j' /2 z.colcity 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 77 0 P V' -" 'c LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION Pu) OWNER (Name) (AditA (Phone) 6e12--g03 . 6 W7 (Address) / )d t 0441 U/ W 044 4./ �Q vame (Phone) 0)27-Pi,-63-Y f- (Address) S''2 Y2-699 C /jive 4/, 9, 1 y� ✓ u S d� //�� (Address) (City) (Zip Code) (Contact Person) 4o ra l/ (Phone) APPLICANT SIGNATUREa/4121---444.__ DATE /d / /C 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 1. Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks 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 $ Z.577 Building Permit# PLUMBING PERMIT FEE $ 3U STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ Sds, (Office Use Only) This Application Becomes Your Building Permit When Approved Paid gj c7 ) Receipt No. 3 ( I S Date 013_ By 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