Loading...
HomeMy WebLinkAboutPlumbing Permit 11. 1141 0 000000 o > 2-0 § , o o 0 c §Iwzioo z $ $ © / 71 » 73 q = r - 0 � o \ j \ 9 § \ � §k } - § o _ q q . , z 2 0 2 Pk 773 0 ( o a 5> 0 0 z o \ z ' q A 1 hi ƒ » § § f ' r I Z }/\ 1111% ' 000000 \ \ `/ . 72 " $m/ ■ M " 0 m =■ -t, 0 ■ k \ / § m ]§77 7 q 0 ? > 0 6 0 r--nRR • 2 . 0 $ \ n \ ■ ∎ / 13 k P e / I A. 0 2 c 0 � ® \00000 ` omm j -a_"D % / m .��� - -n ■ ®- -I 0 z m w 0 C.1),-..194 V Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT Jn'NESD 'cP I. Blue File 2. Gold City PERMIT NO. I ( 1 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS / , ZONING (office use) LIS I Do t10- S S L LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (Name) - Dr r 1 ne ( A.-2. k,I (Phone) O ' LI - 7- 433 I (Address) 5 I / • w& Si SC APPLICANT (Name) 31 - 1815874 (Phone) (Address) Appliance Connections Inc (A1,04 Danita Circle (City) (Zip Code) Shakopee, MN 55379 (Contact Person) (Phone) / APPLICANT SIGNATUR4, i PRUM DATE , I 1 1 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 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 $ .__ �� Building Permit # "SURCHARGE" has been extended / 5 e V until June 30, 2013, PLUMBING PERMIT FEE $ l The minimum surcharge for a STATE SURCHARGE $ 0 "fixed fee" permit is $5.00 TOTAL PERMIT FEE $ S ' . YY This Application Becomes Your Building Permit When Approved Paid 5q0 R Ipt No /_ 444i 1 • Buildine Official t (7 cial Date 1 . 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 t ::›411 zhoilot-orle:") 91r 9$7110 660 MM