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Building Permit 11. 0029
- 0 0 1 n 000000 7 0 > % g O cn� -� 33 0 & ° O k § / �� k } 2 / - -o X 7J xi c \\ k m m = -1 P � k k .1.. 0 0 m /\ Z z 0 ya 2 ..... \ 2 \ m 7 n > o ] 2 \ § q ) ¥ 13 , z x00 ` �� 000000 m §mm &11 ® *■� » / / ( §§ . §k §�� m o q 10 2 \ m ƒ m >000 3 Z m m 0 r %oo 73 - p E q_ o z Iqc § rk m % z 7 m '� ` � �� ° 2 k 0 � �} I m 4 � 0 0 .� / 2 d00000 ( "1 71 -1 z z ili w m ' & § ®mm ■Q \ NI - I : - 1 � ?t\ § / % § F© K § 0 53 -n� ® 2 4 m 4 0 r 1. 0 . Rj Date Rec'd : .4.P CITY OF PRIOR LAKE PLUMBING PERMIT �, M 41 : 1 VNEs 00 I. Blur File A Gold PERMIT NOW / /� cod pp / / O O �(// 3. Go Applicant ( 1 (Please type or print and sign at bottom) ADDRESS ZONING (office use) )L73 '1 /fa7 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER !4ckQ('J � ( ) r � Phone (Address) 14 l .7 !'Y frrp ()- �R, I I APPLICANT .---, -35-44._.-35--0 (Name) --�— 5"1"�7- =N5 4 11 01\) Lam-- (Phone) 4 • (Address) 4()J4 OC" iS 1 ' tpi..5 55`t'6 (Addres (City) (Zip Code) (Contact Person) '..- / •'one) APPLICANT SIGN . - -i=i' � ----------/ DATE 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 1 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 The Minnesota Statutes $ 32613.148 . Est $ Building Permit # "SURCHARGE" has been changed for one year effective PLUMBING PERMIT FEE $ .Iuty 1, 2010, until June 30, 2011. STATE SURCHARGE $ 5050 The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ 5 i 5 is Is beginning July 1, 2010 This Application Becomes Your Building Permit When Approved Paid 6 - L 5 7 Rece' No. U Co / ( G, g O Date // (( Bui Official Date - 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372