Loading...
HomeMy WebLinkAboutPlumbing Permit 13. 174 (2) 5 0 D 0 000000 II 0> "n A 0 ° 0 0 0 co - x m k /) k§ k m m z� / -/} Z § q 7 m / f 0 I m / § � Q P 2� q k 0 0 - 0 0 Z � § T1 $ 7 0 § ( 0 0 k \ 3 > z> 2 � m m 2 r. ° ■I m 0 z k IMI z m 0 0 { 000000 ' q g R§ ■ "0 ® *■ 2 -1 0 °° § -1 §E / \ 0 ? m © - n ! 1:1 n 0 :1 % § 0 � z =13z 0 ? 8 0 ' L r-nR§ \ 2 / m ® o z k z } m K cc z m / o -DD g 0 § m ® m c 0 / ® k ` 000000 } z 4 >k \ 0 § �§ 2 I- / Z A \\ C § / m - \ mm § _ _ �- c ® K q § { 04 VRIo� Date Rec'd a c CITY OF PRIOR LAKE PLUMBING PERMIT 73 4 I 6 2 5-??- se c__ b ivESO�� 1. . it z, FiAilry PERMIT NO.I� 74_ 3. Yell ow Applicant f (Please type or print and sign at bottom) ADDRESS _ ZONING (office use) /6; go OUL Ave 5 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER , �� � itaLe.l 11 — ),, , �,,� (Phone) �� -- �7 - a (2y (Name) (. 0.1 , ►' ` �C 0 (Address) (6 gO g. dui A■ Si P or / " / 5s 3 7 . l APPLICAN ' ��� "--2 Q (Name) s g ,Its_ (Phone) � � . - ��- ,-/'X-- (Address) ®/ 4) - S s A. ` . (Address) 4 (City) (Zip d vK (Contact Person) G- 502. 1 41 a - (Phone) APPLICANT SIGNATURE 11 � '. - - DATE p2 / T 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 4 . , 0 , /G, pov,,4, A}- 1 ., , X) //, 2 C? &/ FEE SCHEDULE ! / �y� o - F C Industrial, Commercial & Multi - family 1% of job cost with a $49.50 minimum Residential, New One & o-Family $149.50 o Residential, Additions & Alterations $49.50 Estimated Cost $ l eV Building Permit # The Minnesota Statutes § 326B.148 "SURCHARGE" has been extended PLUMBING PERMIT FEE $ Li9. 3 0 until June 30, 2013, STATE SURCHARGE $ 5 - ff The minimum surcharge for a TOTAL PERMIT FEE $ _aZigi3 "fixed fee" permit is $5.00 ... ...,...ping Permit When A t pro ed Paid - 0 Re t No. (ive 7 '. /id ..,. . .'" � Dated . /3 . Buildine Ottie :1 ' Date ■ 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372