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HomeMy WebLinkAboutPlumbing Permit 11-0916 O O n 000000 1 3 0> 2n cn A 0 a 0 §/ 0 2 2 0 P0 0 m m z �/ C/ 4 - M k § m \ � § � k� o 0 A R ›§ z m Z 0 ° — z � q s � � ■ q CT z q \ C ��/ j m m m z ■ N Z1 - ,, 0 3 / \ y 2 0 0 000000 4 1 m - mm �r ®s © � 2 ® 3 °° c) 0 - 4 CI 5 Z 2 M i q_ §273§ m o 0 zt ? m 2 § > 00 0 3 x zt % 0 \ 2 r Ikk ® c § z } -- ,-%§ Z r gi k 0 § m '-----C § k § D ODO i N z > _LD R. § cn mm30 - » § 0 ,. , - § § 0 mm m Pig 2 -4 � m � � K � 4 pRI Date Rec'd � CITY OF PRIOR LAKE PLUMBING PERMIT 41/A'NES6C-P t. Blue File 2. cold city PERMIT NO. ii / GJi (O 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 1 pep.,- C;R.ik Dn .) t ss LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) i Dui rl (Phone) a ► 8 - Z S I - t(3►1 (Address) APPLICANT (Name) CULLIGAN WATER CONDITIONING (Phone) (Address) 6030 CULLIGAN WAY kligtfATONKA, MN 55345 (City) (Zip Code) 2) 933 -7200 (Contact Person) (Phone) 1 APPLICANT SIGNATURE I - I DATE C� - ► ) - 1 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 ,l Residential, Additions & Alterations $49.50 t $ 11 G 19 .0 0 Building Permit # The Minnesota Statutes § 326B.148 "SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ 1 }1,5 0 year effective STATE SURCHARGE $ 0 0 _r 6' July 1, 2010, until June 30, 2011. S The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $ _54 . 5 0 is S5, beginning .luly 1, 2010 This Application Becomes Your Building Permit When Approved Paid. e eipt No. / „ � v or lC/ Date n Buildine Official Date ` 11 I4 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372