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HomeMy WebLinkAboutPlumbing Permit 13. 0247 0 J w _z N J 2 LL ~ 1\.\. N. Q Z W e ` 0. 0. 0. 0, o 0 2ww� +� ( �oxara.� z a w o �/ W UtiLL 2 z ri 0000N .. W tL 0. Q W Z rel 0 • ii I O .,J :, : , z O O a. W - .1 I- �' 0 0 0 U' < P U 0 qC ? 0 c 0- o 0 Z —xxZ (1) �!\ 0 w gxw ► 3f a 8 z o 3 '�J JLLJQ jJLLI v W W z W O a 2 w 00000 0 O O g z a a LLO x N ..` c.J CC Z a o w W W '`!,, 0 `t U U. cc� 0z o p. 0 w 1.-- ~ d r.. a a� vJ z zo?g z W J N 0 LL 0) t`J o o oo��LLN ''O 0 U. u C) x Z Q \i: U U y 5 z Q O D. 0000 ❑❑ 0 9 ❑ ❑ _\ k 1 i j e � ii yww \ � / / ■ A d / Sƒ 7� 0 c ce , OOOOO / $ 0 / d Q w o & re _ . LIU ..1 / @ a. a. / � L � ii oo�� m k 0 k 3 z \ k2��2k 0 \ 0 co ® / U co LL 0 c W \ 0 k� 0. 0 ? ® ( `�) a ■k o 0 0 w 0 4 0 00000 0 Q 2 w 2 1.- o o = � \ E E / ® \ / f ` \ 0 ~ 0 §� 0 z U a 2 $ Z _ o w I-. P m 0.c‘ 2 2 z 2 Z ix W / / a �� w © k§3 7�i * � w § (Si 0 7 z oo /2 /K ) ƒ ƒ & a / U� < 0 a 000000 q 2 0 0 2 0 0 0 a pRI Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT 41 jNNESDc -P 1. Blue File 2 Yell A PERMIT NO . . pp -2�/ 7 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) Ltc5 Y1 CV. t\I LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER /n� � 1 �/� (Name) T, r V b o e-I t (Phone) � — �CJ�J Zsi (Address) APPLICANT (Name) Appliance Connections Inc. (Phone) (Address) 12850 Chestnut Blvd. (Addres ' 952 - 445 -4803 N 5 379 (City) (Zip Code) (Contact Person) (Phone) ?� APPLICANT SIGNATU • A IAA A 1 U 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 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 § 3268.148 Est $ Building Permit # "SURCHARGE" has been extended PLUMBING PERMIT FEE $ until June 30, 2013, STATE SURCHARGE $ ', h6' The minimum surcharge fora TOTAL PERMIT FEE $ "fixed fee" permit is $5.00 This Application Becomes Your Building Permit When Approved Paid 6 r — iN I Receipt No. Date ?AO By �° Building Official Date U : 3 �, ul 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372