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HomeMy WebLinkAboutPlumbing Permit 11. 1294 1u 7 -/ } G C4 u. w. W R3 \ kgg4 \ \ , \I22�� 9 C3 \ 2 tii N k o ««cc z ® wo� �o\ \ © - 0 0 0 0 00 Kg \ k @l U z - u. « t / 0 \ z 0 ~ * \ e \ \ E / \ / \ \ k w 2 _ ? ?7§ � ƒ f ® I 0 z ) \§�k\ 2 S § j / } �§ \ a� z (-) -.. OooecO ® ) § § / 4 c g r Ili z w re w� \ � ` 0 \ z < w § z4 p z z @ r-: / \ 7 I- u z < 1 - I• \ EL p z z m ) Lu a .« 44 0w § ■ W o n * < iu , \ \ \ u �a 0 ' z E° § ki t 0 O 0 § 2 2 0 1 00000 U E PR IG OY Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT " NNESOV 1. Blue File PERMIT NO. % /` /2_94_ 2. Gold city ! ` 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 3o\ rs,nA W E LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (Name) R V I 1 0 C O, (Phone) - (Address) SCA/Yr .e, Pr U'r 553 9 APPLICANT Champion Plumbing (Name) # 61770 -PM (Phone) 651- 365 -1340 (Address) 3670 Dodd Rd. (Address) Eagan MN . 123 (City) (Zip Code) (Contact Person) \ 5 0 (Phone) APPLICANT SIGNATURE / /ii �= DATE APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity, Type of Fixture Bath Tub with or without shower Rou - Dishwasher ` ater 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 $ .44; ' Building Permit # "SURCHARGE" has been extended until June 30, 2013, PLUMBING PERMIT FEE $ The minimum surcharge for a STATE SURCHARGE $ S .. ' "fixed fee" permit is $5.00 TOTAL PERMIT FEE $ 5 L. so This Application Becomes Your Building Permit When Approved Paid j s Rec p No. 1(1 2i Date /4, Z . By �( Building Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 l 0 ? .g