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HomeMy WebLinkAboutPlumbing Permit 11-0482 — 0 = 0 000000 - 0 0 > 2 ] n n O C 1 m 0 z 0 �) ✓ r} 0 k\ C §r z xi / §§ rn m m > z z n 2 2 _ G . ) g 2§ / _ . § . § 2 2 § q •\ • o I z ' §\ m n z a z m m 2 m § 2 �� k z x 0 0 000000 "n q mq§ 1 m��t�� 2 ® 3 ° ° ?gym ?& 0 » 0 m _ _ \ m / j > C)o o 0 K - ' 0 , § - a r \ m =1 % E § 2 \ z I )) z . m d 2§ Co r -o -0 P \ 0 V. 0 - X • I ( m 2 00020 NI X z m r®m-nnm �§ > f )qc/ R. > m /��> — q ƒ . agk § k > § � (.(pRfo Date Rec'd 4 CITY OF PRIOR LAKE PLUMBING PERMIT 'CO, ,/ // 4fl A'NESO 1. Glad File Yell A PERMIT NO . // 0 3 pp / V 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 1109 log 1,11 A„fax -- Tir _SC -7 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) 1.-.0.1( k q PI 0 r (Phone) b r a- a 3 7- 83 L3 (Address) 1109 A q W \ \ COPY rm SS — v SE APPLICANT CULLIGAN WATER CONDITIONING (Name) (Phone) 6030 CULLIGAN WAY (Address) MINNE_TONKA, MN 55345 (i 9 s 33 -7200 (City) (Zip Code) (Contact Person) (Phone) L APPLICANT SIGNATURE L DATE - (-1 i 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 I 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 The Minnesota Statutes § 326B.148 ;ost $ c 00 . 00 Building Permit # "SURCHARGE" has been changed for one year effective PLUMBING PERMIT FEE $ 41‘ 50 July I, 2010, until June 30, 2011. STATE SURCHARGE $ S.. b0 ,.5$ The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ . Sy . 5 0 is 55, beginning .luly 1, 2010 This Application Becomes Your Building Permit When Approved Paid s -/) Recei t No .6 11 7 / , 0 9q Date I , ` 1,1 By Buildine Official Date l "� 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372