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P - 48660`;Li i:.�ii2�? � i`'�.;�.TlF`��i��`+��.;: p,,, � r-�� y j � --h,..,..�; --, ,F,r �i .�,,,�j� . rF,� � i Yi2S;��.,`�l�_: ; "�.��i�.,<��` �. � � ^� � , �i� � ��...-�`'� ; V �'_ i;;{iL.? i ,-yF�T - fE� i�,._c�l�� r'��_ 'r., `f�^.- �.L L � Li� C"• C' �� — . , 'c' 7�? Jii_ . � . " � �� p7 , ^7'r�ir - -�('�^ r�.=��r `f-! �i � �rr� anu�:�s� J'�gl� TI-IIS APPLICANT IS: P12�x'�R'°'i� �� '�� C�N'�'�1CiOR su�Mrr� ,a co�Y or- YOUI� STAT� I,IC�NSE. BOND AND C�RTIrTCATE OP 1NSURANC� PERMIT TYPE TYPE OF WORK: �� our� c-n�ni� ;�.�vi�i�s� _ >�f-. N� ❑ OWiJGF �ON'PI:1��TOR ♦ A `h' ✓'�./✓1 � SC�M � S � °ermi� Na: ; iceceive� n��: � � �" , ; 4 ✓��v-�:P�? � � �� I ADDP.LSS: SO�� " �'T' 'v� CiTI� Fr� � It�-/ s�raTvy►nz�N��/3a- r>,-�orr r:: 7�i 3- 57 /-/G d�i N�M� ��-r C�: M �' _ s-r.�T� Lcc�NS� # PG. (0 4a 37 exr Df�-re !al3/ I STAT� BOND # GXP DATL ADDrtcss: Fi'a-� D M� � n S-l-, �-3� ciTS� F�_. d(e H sTATL(Y1(1 ziP SSy3 �- PHONE (� 3—�S�% a-t9 S r�x '6�j-757�--o2g0� G7'SINGL� FAMILY ❑ NEW DETAILED DESCRIPTION OF WORK ❑ TWO rAMILY ❑ TOWNHOUSL W'I�PLACEMENT FEES ARE BASED ON $] 0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER.OF EACH BELOW). MINIMUM PEE $35.�0. BATH SINK/LAV _FLOORDRAINS SHOWER _WATERPIPING BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER KITCHL-N SINK WATER CLOSET _BACI{FLOW PREV. ($]5) DISHWASHER LAUNDRY TRAY ✓�VATL-R HEATER ($35) FOR IRRIGATION — WATER METER _ OTHER Number of;f�tures. @ �3.5:00 ' x.$35.00 = $" " State Surcharge;;. ; $- ' S.0.0 �MTNIMUM $4d` 00) Total = � � � • � � TIIIS [S AN APPLICATION 1�ORA PEI:MIT-NOT VALiD UN"PIL PROCLSSL-D 1 hereby apply ior a plumbing permit and I acla ledge that the infonnation above is complete and accurate. d�at the worf: will be in cot�formance ��vith tl�e ordina��ces and cocies of he iry of Pridle}� ai�d witll t�he Mini�esot� Consn��iction Coties; that I �inderstand this is uoe a permit buC only aii applicaiion Por a en it an i wori< is not t�o start wi�lliout a pennit oti site; Chat tl�e worl< will be in ziccordance �avith t'he approved plan in �� :ase rf �� c�r �� ilicl requires review a��cl approva of�plans. SIGNAi'URl;r)P:APPL1C�Ai�i` PRIN'1'?JiAMLi� /'l a.O� DnTI� �—!� %c�. 1P�'1�C?VAL aNSY��,:. (3RS S3C'AlA.�'U'2G I� V 1'' — — � ':?L�.�.�C NC)T... � �Eo!'�R:=�`"t. �?E :t� i .� ; _ . EC,7[;IfZ._� '='(�R BC.�.Li�:N(i: � �,i�C �^�ICr�.I, `1D !'.IE..�i-i,�i 11C,=Ai; .� (�RL� _ 1C"� ;,:� `� ;;�11Fi�� — .:�i?$;l}�:Il�n` i�9Jr��,""'w1Q�iT1':,�' i�P",T,�L"��c�^3i' J�=� i Jill ;�C, I[' ra VE;111;:: `��L. �1�:, /il i__ ...: �t�J-� i ~. �(Jl)4 _ , .1>. i �) �-�•li_-�� .