Loading...
HomeMy WebLinkAboutPlumbing Permit 12. 0069 0 0 0 000000 0 > zg § n \ k° C in -n 0 m R $ � m >c m m m M \ / \ \ / §� % k \k � \ \ § \ k k % m \ z 0 2 \ o ~ \ r » t ® 0 . - Mm m © E §7 I � / » -4 O 12 - z X00 000000 i \ Z ` m r >mr M E o - 7&R§}& \ 2 2 m @ gy m ■ _ � § -0 0 m 0 0 cn m- x >000 0 3-i m % d $ 0 % , r �oo o t 0 } CO > c c z § / 0 . ��� r _ / m - �1 § » < \ ` �00000 C � � / 0 § 4IH � § � o t-,1 R , _,kk %7 mm■ r -4 F. m -1 r - 0 V P RIO Date Rec'd o e CITY O F PRIOR LAKE PLUMBING PERMIT E I L-.- Z 41I NNEs 6C 1. Blue File 2. Gold City PERMIT NO. f Z _ ( 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 03161 v,.cfkii‘,... r ve_. LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID ((Name) a / (k U ?or 4-1,00 001 (Phone) 4 17 _ 7 (27 / (Address) Sam/ , -s �� - P V" L 4l.JC 5 n ,3 7 c APPLICANT (Name) 31-1815874 (Phone) (Address) Appliance Connections Inc dd 3 Danita Circle (City) (Zip Code) (Contact Person) i . , • • = e MN 55379 (Phone) qi , 4 Li l ° q,+1 e • APPLICANT SIGNATURE LI /Mk. , - , e A. -a! DATE APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough - ins Dishwasher 1 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 I% of job cost with a $49.50 minimum Residential, New One & Two - Family $149.50 Residential, Additions & Alterations $49.50 - 9 5 1:) The Minnesota Statutes § 326B.148 st $ Building Permit # "SURCHARGE" has been extended until June 30, 2013, PLUMBING PERMIT FEE $ The minimum surcharge for a STATE SURCHARGE $ "fixed fee" permit is $5.00 TOTAL PERMIT FEE $ S '50 This Application Becomes Your Building Permit When Approved Paid s ,1 go Rece t o. 6 ', 4 . 99e , Date / 23 / 7 Building Official Date ! e I C.i • 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 4Teerst te -!9• fi ,,,?ec.o.tfirue