HomeMy WebLinkAboutPlumbing Permit 10. 0986 0 0 n 000000 7 0> %0 6*\,. 0 m�zmn' 2 2 m �
a
§ n 8 - \\ 2 2 m § D E C O m 7) r OM
oz ® 71
2 § § § 2 % / B >Q § �k CN k f \ § § j % §
2 0 /2 . } m m
7 2 > § , � %
q
\ § x 0 0 . I 000000
\ - m ) \ � . r \ M
2 z i - 0 o A Ir \ $ § rni _ § m o q
\ k T g m �
>000 0 k )
§ 6 � r �oo 73 a (.,,
q \ 2 5 I 0 \ m
2 s m ��m 0 111 / fg 0
m
0
C 0 �
0 . \ 00000 o
\ 2 ? ,-> 3 0 § \ §
% 7> 0 r���
2 • ■ mZ �
\ A 0 �\- - 2
- 1 Z m
qr- 0
4 p RIp Cj Date Rec'd
.4e CITY OF PRIOR LAKE PLUMBING PERMIT
N 'p
x
U (Ti
JNNESO°
t. Blue File
z. cola city /
P ERMIT NO. / 7 g ( ✓
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
M(Q r SW
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
i
OWNER mo - ?....ose
(Phone)
(Address) SCUYY\k/
APPLICANT Champion Plumbing
(Name) # 61770 - (Phone)
651 - 365 -1340
(Address) 3670 Dodd Rd.
`
(Address) Eagan, MN 55123 (City) (Zip Code)
(Contact Person) `I 1 v ' (Phone) ^
APPLICANT SIGNATURE _ DATE s, V
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower
Dishwasher ` W
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
ost $ v Building Permit # -2. The Minnesota Statutes § 326B.148 r-�y
"SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ `-T
year effective STATE SURCHARGE $ MD
July 1, 2010, until til June 30, 2011.
The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $ ii 0
is 55, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid 5 1 52 I ec No. C� /_ /6 2.,z___ 2.,z___ Date - U ► y
Buildine Official Date /O. 2 _ ,
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372 LI -7- 9 '\Q ur