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HomeMy WebLinkAboutPlumbing Permit 12-0084 FA O 0 000000 , 0 › §n n n * O ■ II 2 -n -n - n § § § ;4 el a 0 m 73 2 s� »CEc§ m , 3� 22 k In m m z > z z z 0 0) § - u % ` -, § -4 m SC 0 z - 10 " ■ . C n Z z • §■ 0 01 • ��� z n % z wi 0 x NI 0 g > © 03 m 721 r 0 a. 'V V § 0 0 , ® 000000 41 r>1 § m m gc ® ■ ®1) ® sm o z o o � i& m n ` ■ | k 13 f m -13 zz=Z - z 71§ x ` E m - _ >00 0 3 v h 0 0 0 r xi * 0 z ' m ' � 1 - 13-0 z m O -n 0 / m PI (--- -- O . OOQOO § o o az < r -0 -0 0 \ 0 / \ q § m XI -n ■ r 2 - z m r 0 "N PRIp Date Rec'd N �A CITY OF PRIOR LAKE PLUMBING PERMIT fIi'NESOcY 1. Blue City Gold PERMIT NO. /2 City 1 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 5 ^ � HOAria,r EC LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID 21,3 e,OO 7 • O (Na OWNER 41 (NOY) 1 1G1 V Ct'VN (Phone) Col ,3 ' c 0 - al (Address) � S J 37--a, APPLICANT (Name) n Plumbing (Phone) � Phone # 61770 -PM (Address) 651- 365 -1340 (Address) 36/0 Dodd Rd. (City) (Zip Code) �.� Eagan, MN 55123 (Contact Person) �- (Phone) APPLICANT SIGNATURE DATE 30 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Ro Dishwasher 1 r Heat Floor Drain 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 Most $ a ��� � Building Permit # "SURCHARGE" has been extended PLUMBING PERMIT FEE $ until June 30, 2013, STATE SURCHARGE $ • ° . 317 The minimum surcharge for a "fixed fee" permit is $5.0n TOTAL PERMIT FEE $ This Application Becomes Your Building Permit When Approved Paid --v Receip o. Date t By Buildine Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372