HomeMy WebLinkAboutPlumbing Permit #11-0180 y ❑❑ c� ❑❑❑❑❑❑ � o a Z�
� n n � � -��iza,��� z � °� m�
� c) � ��� 3 m>c�cg m 70 ^� �,�,
b a o � 3 z r 30� v �
tr� � m y m tn �Za� O O�
� ,� � y Z �o o�� z
� —I m
10 D V� n Z z O�
� n � � �
� � - � n Z ( ��
t� O n D � mm
� � z
� v �
_ ,� v v
� m � o o ❑❑OOO�
m m m m 3�y���
x m m mc D
� Z �°° i���i W m n � y
� c � � cmi z� 3 � m
R+ p � � r� � _� . r�'' c°
� O ? m �v� � v
0 N O �
� A �
= m
� c o � .
� � < -��0000❑ (�
y Z � �t �t f') [ � �
� D � yf111T1�� m
� � 555�
D m �
►� Z >mm
� m ����� s
'- • Z m
-� � �
� � pRl Date Rec'd
� �� CITY OF PRIOR LAKE PLUMBING PERMIT
� x
� r�
�
,. s��e F��e pERMIT NO. C l I �
2. Gold CiTy
3. Yellow Applicant �
lease or ' t and si at bottom
ADDRESS ZONING (oflFce use)
15`1a0 �I.� �c��e,� �i r� �.
LEGAL DESCRIPTION (ofl('ice use only)
LOT BLOCK ADDITION PID
� `;�i�f 1 l W.��/�/I /CJ (Phone) ���— / / / �v7U�
��� t'
(Address) r� (� �
APPLICANT
(Name) Champion Plumbing (Phone)
(Address) 651-365-1340
Ea an, 55123 (City) (Zip Code)
(Contact Person) S (Phone)
APPLICANT SIGNAT � DATE �
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture uanti T e of Fizture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laun Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
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 �st $ Building Permit #
"SURCHARGE" has been changed for one
year effective PLUMBING PERMIT FEE $ • 5 �
Juiy 1, 2010, until June 30, 201 L STATE SURCHARGE $ . O
The minimum surcharge for a"fixed fee" permit � TOTAL PERMIT FEE $ O
is �,5, beginning July 1, 2010 —
_ __
This Application Becomes Your Building Permit When Approved Paid 5�{ _ I C71 R c ipt No. /_ Z � ��
`T" JU �O
Date �J � .ZS r � � '
BulldinE Offfcial Date
24 hour notice for all inspectious (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372 � O I J�'2
� 1S �
cwry , `�a,
._ ^ . . ` ' ,�.