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Building Permit 10. 0786
- 0 0 d 0 0 00000 7 3 0 a z / n / \22 C jkk§ 2 \ 0 m $ § §m§ m 2� § z§z § @ d� nn Z (4 z- • R k > j 0 Z z § @ % 2 0 .Ti 0 — - • � 0> 0 f i c m m m 0 >r z f , i \ § 2 / moo 000000 jj m )km , C " ® 5■"0 § -I0a \ E / r ;' \ /23 23 m O 0 2 0 m 0 zZII z A z\ i ': ; , e , > 0 ■ ¥ m § \ z ' �k /\ z / • 2 § m � ` �� r mm g m / I / ^ \ w • q n . � § < r te ƒ \ N i Z 2 o 23nm § R. > �2§ %2 "I <� ' q 0 \ >mk\\ ) m k § 0 ( 0),,iti—cis D ate Rec'd . CITY OF PRIOR LAKE PLUMBING PERMIT F .,= i • Dan Meyer V °w 16842 Westbury Avenue �NESO� Prior Lake, MN 55372 1 cola File PERMIT NO. /� �� 9524405045 Y / 7 3. l ow Applica 7 (Please type or print and s ADDRESS I / p s , __ , ^ / Dst bwr , ^ w ,� ZONING (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER Dan M i er ( Phone ) () ` JDt15 1 (Name) � Q S1-1-2- p p (Address) `� L S(' .Yt/ APPLICANT (Name) NOKI3LUIOI hLUMBING CO. (Phone) (Address) 12) 827 4033 (Addy 05 GARFIELD AVE. SO. (City) (Zip Code) (Contact Person)ft I MINNEAPOLIS, MN 55408 (Phone) APPLICANT SIGNATURE l i DATE 9 / / ©/ / 0 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins Dishwasher I 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 ost $ 0• The Minnesota Statutes § 326B.148 OD ' Building Permit # "SURCHARGE" has been changed for one 5U year effective PLUMBING PERMIT FEE $ / July 1, 2010, until June 30, 2011. STATE SURCHARGE $ 5 .p0 The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $ . 5ca is s_5, beginning July 1, 2010 I This Application Becomes Your Building Permit When Approved Paid 5/..f leipt No. Dater ( y Building Official Date G �� ``'' � W 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 ' 4646 Dakota Street S.E., Prior Lake, Minnesota 55372