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HomeMy WebLinkAboutPlumbing Permit 11-1138 0 O' n 00000 -0 0 > 2 in § n a 0 0 ) )>c,.O m m§ k m a o M r ■ i S r e m m � m Z >Ea2 z u) �� \ � - n 2 q �o�o g z- J I d -1 m 5 5 0 Q > z § ° � � ) ~ mm \ 7a r X -n 2 - 0 \ m 2 0 0 000000 Z m m m r ter® ;r 2 ® 3 ° ° 0 , O C 1 0 c 2 K i m % § m 0 0 § ) 2 m q > 0 K-4 1 m k - o 2 2// z I, § / Z •• m r - '0 0 I 0 I §� 0 _ k / ❑c=O , - 2 2 �]]�2 § 0 ® E § -0 -0 \ 0 §M /t§_ A � �■® -I t z ■ r RI Date Rec'd ` CITY OF PRIOR LAKE PLUMBING PERMIT 1 x M M �� NESD� 1. Blue File PERMIT NO 2. Yell City NO. p / / / 3. Yellow Applicant (Please type or print and sign at bottom) DRESS Che&\iu- Ln ZONING (office use) —L H LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER `,� N�+6 eArs ©Y1 (Name) Y �� (Phone) (PS' (Address) APPLICANT Champion Plumbing (Name) # 61770 - (Phone) 651 - 365 -1340 (Address) 3670 Dodd Rd. (Address) Eagan, MN 55123 (City) (Zip Code) x (Contact Person) ft c (Phone) APPLICANT SIGNATURE `i DATE I.d -[ 1 t APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Dishwasher t Floor Drain 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 t $. Building Permit # "SURCHARGE" has been extended PLUMBING PERMIT FEE $ until June 30, 2013, STATE SURCHARGE $ .50 The minimum surcharge fora TOTAL PERMIT FEE $ SU/ SO "fixed fee" permit is $5.00 j This Application Becomes Your Building Permit When Approved Paid 5 .0 ' - I Pt Nq. 1 I l4 Dat; By Building Official Date ' . ' '1 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 D ce ic 9- 1-fri)