HomeMy WebLinkAboutWater Softener Permit #12-0105 pRj Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT 2 _ 9. I L
4! I "NESO�� Blue File
2. Gold City PERMIT NO./ 2 r / O
3. Yellow Applicant ,
(Please type or print and sign at bottom)
ADDRESS, ZONING (office use)
q 0 OaXujOd GAY '
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) 1 , , /. (Phone) / ' 4►. - _ .1.1- _ .0 A
(Address) (n q V b1LtC-OOOd (1•
APPLICANT A ppliance Connections Inc (Phone) '`
(Name) 1313 Danita Cr ( ) i
A `�
(Address) ss 55379 (City) (Zip Code)
( chk opee, MNI 52- 445 -4803
(Contact Person) A (Phone)
3 1 �)� APPLICANT SIGNATURE DATE 04:31C9
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
Cost $ Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been extended PLUMBING PERMIT FEE $ r .5
until June 30, 2013, STATE SURCHARGE $ 5. 0 -5B
The minimum surcharge for a TOTAL PERMIT FEE $ , •
"fixed fee" permit is $5.00 — —
This Application Becomes Your Building Permit When Approved Paid 3i Rec• • No. 6 - 74._
Date .�. , ' Z B ,
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