HomeMy WebLinkAboutPlumbing Permit 11. 0020 U r '.1 _ ,
r- J a cZ uii
u,ZwwQ _ 0 w IR Sag o '
i c9 2 WW to Z Q
i t V 11.) 5 T T. MLI E z ti
w
U ❑0 0❑❑ ,
v0 O
Z
LL o N z o
O n m O .....1t.
W O ' �¢ Z o W QC
H t Y o o u. _--+ p O 0 0 QC
W OC , P w a c
2 S Z a z_ZIZ? 0 y CO -
0 0 w 'm =Wam= ► a O z
1 \/' ° w w z x u_
a�3a� t w w
❑ ❑ ❑ ❑ ❑ E7 . \U 0 0 O Z
0 0 z w
II. Lt. IA I-
K O Z U O W
a u.
^-- ►- z o
re 1 z Z U ` H U O a; W
Q n a
O Z 4- O D a Z N U U W
�� v Z ►= ° W EY o U
O a w Z o o ' o d tnZI- O 0 0
U
F to 0 0 u. ti LL Z U. to O y 0 0 a
U ? 4 O a 0000❑❑ 0 O ❑❑
VRI Date Rec'd
.4 CITY OF PRIOR LAKE PLUMBING PERMIT
i.t", ,I : k4C /, i 6 i t 1
diI NNESD 0
1. Blue File
a cola City PERMIT NO. 00 10
.
3. Yellow Applicant t
(Please type or print and sign at bottom)
ADDRES . r ZONING (office use)
HaI V T w 1
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID igt
(Name) R a ■ & I (Phone) W I "tS 6 '
(Address) S c e ! Pin OYY La
APPLICANT Champion Plumbing
# 61770 -PM
(Name) (Phone)
651- 365 -1340
(Address) 3670 Dodd Rd.
1<nS (Addres Eagan, MN 55123 (City) (Zip Code)
(Contact Person) f (Phone)
APPLICANT SIGNATURE DATE I H-11
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Ro -ins.
Dishwasher I ater Heat
Floor Drain Water oftener
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 § 32613.148 ost $ � � i 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
is $5, beginning July 1, 2010 TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid �� S T Rece No. 6/0 74
Date !D / /
Buildine Official Date / �
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372 /ooV 5 Po