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HomeMy WebLinkAboutPlumbing Permit 13. 147 ■ ait � § g 2 :44 � � :: ki ■ 02WW )% 2 CI 1 b 0 � ■ CL $ , OOOO § X § J _ Ni. cc § u. 0 • d $ § c o 2 z 2 x ■ 0 z o m o �� E e o • §�� . o v 0 / � _ 2 § 2 § g ma, § i co 0 0. ■ ■■ 0. 3 ■ s=ul§■c II U3 d 0. �� 'I §§ � 2C 04 lb 0 0 o000 §2 § t • ik a a 0 - re 2 E 2w 0 o m 1 P C6 0 2 ��� % ■ 2 § z fa © a � g 07 Z 2 k 2 1 _ a. W � � � 2 ■ § ■� ■ ■ 2 0 2 / § § § UJ J 0 k E o $ 2 0 a 000QOO 0 c0 / 4 pRlp Date Rec'd N CITY OF PRIOR LAKE PLUMBING PERMIT v _i•N�S ° I. Blue File PERMIT NO 2. Gold City NO. 3. Yellow Applicant (Please type orprint and sign at bottom) ADDRESS ZONING (office use) I5a9y Oa 1 C �� c-I SS37 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER f\ (Name) JaN k C X \ -\ \ (Phone) 70Q.- 3 - 3 (Address) 15a 4 `f O dl c, ,� Cvr , APPLICANT (Name) CULLIGAN 1NAI IyH CONDITIONING (Phone) (Address) 6030 CULLIGAN WAY lyitaNWNKA, MN 55345 (City) (Zip Code) (952) 933 -7200 (Contact Person) (Phone) APPLICANT SIGNATURE 1 , . _ - DATE o) - _ - ( 3 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 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 Estimated Cost $ / j 1 ` . • 0 V Building Permit # The Minnesota Statutes § 326B.148 PLUMBING PERMIT FEE $ "SURCHARGE" has been extended until June 30, 2013, STATE SURCHARGE $ S 0 0 The minimum surcharge for a TOTAL PERMIT FEE $ 5 30 "fixed fee" permit is $5.00 ing Permit When Approved Paid / 6 -3 Receipt No. f Date By z, j Building Official Date 0/, 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 ,� ry =