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HomeMy WebLinkAboutPlumbing Permit 11. 1339 0 00000 7 0 > %§ O= 0 2 2 -2 -n -n - n o 2 o / n n\ s k -c K M m § § >r \ 2 22 q 2 ��$ Z2 E co -$ © r A A c 2 $ 2 0 - 0' z- \ q En§ 2 z § 0 1 -I 3 q 0 ` B E \ k 0 D. t z rn \ 0 r § f All .......... a / / 0 $ 2 2 1 z m// 00000 . §13 ® tC� \ \ 2 § § - ? 3 K )? & 0 ® 2 ® K \ k \ zi - \ P3 0 ~ m i / § /ERR @ E :i. q \ k > d \k P § \ \ T . { / . . . � 2 c q N OOOOO \ _ k Q23nm L. m >53.530 »i m % 2 2 Z.Egg3 R. Q , m���_/ -- i ®k k % § 'X -n � ® / § q m ®¢ z 0 r 0 PRIG Date Rec'd �° e, CITY OF PRIOR LAKE PLUMBING PERMIT .. c.., 411ArNESC _ 1. Blue File PERMIT NO . 2. Gold City / /j 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 16197 Fish 7-F gd LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER ,, '//� (Name) q _- 77 �� Cl. � � C�/ CJ ,� � � � � (Phone) . 1 (Address) S�; Q Ti (or l�•VI�U i 1 Y V S 7L (Name) . \ 0 Y `N1 ► Vbl V1 (Phone) V (Address) Od A V-trl • IAA t �� (Address) (City) (Zip Code) � (Contact Person) 9c6 0, (Phone) ( 5\ :231-)-- (>L APPLICANT SIGNATURE Alr ' �i x� DATE t Z— I – 4 1 APPLICANT PL AS 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 1% of job cost with a $49.50 minimum Residential, New One & Two - Family $149.50 Residential, Additions & Alterations $49.50 The Minnesota Statutes § 326B.148 'ost $ Building Permit # "SURCHARGE" has been extended e �� until June 30, 2013, PLUMBING PERMIT FEE $ ifq The minimum surcharge for a STATE SURCHARGE $ • v. "fixed fee" permit is $5.00 TOTAL PERMIT FEE $ This Application Becomes Your Building Permit When Approved Paid 5 ik OD R c ipt No./ q- Date i i Buildine Official Date 711. f 4 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 I (M31) 4646 Dakota Street S.E., Prior Lake, Minnesota 55372