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HomeMy WebLinkAboutPlumbing Permit 12. 0048 • )k k -1 ri _c. W E i j � �qq� ,, o ( . JJJz > 2 1 1 - < 0 2 krekkc z < \ A g wo N \ ��o 2 ® * m , j , 00000 w § o ce _ J N / O L , W c z O }jZ Z 0 2 2 e e 0 Q U J . o 0 0 x * z 2 ?77 0 C m \ S S a 2f a j z R q0R §o � � `, co 2 e \ a§2 a� 4 ► ` k k C } O 00000 0 0 § w $ .. a Q. L x o u \ ® 0 J 0 § % X oo © \ P 0 > ~ ^� 0 0 X @ 0 2 z o w / > r- cal � • � ® w w .. g « cz 0w Z 00 W \ § / k k k § ° `) b § § 0 E ° E @u-§ E ■ 0 0 a 6 ? 2 o a 000000 0 qo 0 f ( o P Rlp� ,, .p: kr e 1- CITY OF PRIOR LAKE PLUMBING PERMIT Date Rec'd jNNESO Blue File PERMIT NO. ( Z z. cola city 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) H96269 Pivic Thin-I- cA r LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (N ) BIQCX (Phone) lY ID e)°3 *q4()' (Address) '1 Pri Vr l,'" i s S s 7- APPLICANT (Name) 04196100t1 Piumbing (Phone) 1 . 61770 -PM (Address) 6 1 =365-13 (Address) TWO Dodd Rd. (City) (Zip Code) tagiA MN 55123 (Contact Person) ` (Phone) APPLICANT SIGNATURE ✓yy(— DATE 1 1 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Ro -in Dishwasher 1 ater Heater Floor Drain a er o tener 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 ,t $ C'—.12) Building Permit # "SURCHARGE" has been changed for one year effective PLUMBING PERMIT FEE $ July 1, 2010, until June 30, 2011. STATE SURCHARGE $ .50 The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ /S f �f L , is beginning July 1, 2010 SO This Application Becomes Your Building Permit When Approved Paid - L "73 Re" No.( 7 Buildine Official Date Date r / _ : . 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 I 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 97