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HomeMy WebLinkAboutPlumbing Permit 10. 1079 5 0 0 0 000000 13 0> Eo 2 n 0 ■ �5'�-n 0 $ o § � § a g 2 §§ _ m q M 0q r 0 m ^' m z ■o■ z 0 : 11 § § ®§Q P Zk ro® » ■ ch n& z Z■ 0 0 0 k 0 k z0 , mm ern 2 2 a 7 �� _ i m N/� rn 2 0 O 000000 .9 z § § m �� ■ ■Is E § o o 4 oc2 -10c % 2 / m % . Z ZXX - Z z X E M t `�` >090 © M 9 § § 0 I � zc / . 2 # CO Ilk �' x 17 P / IV 2 o x _ & 0 \ O000O ` o ��n2 2 Re 0 !u -� k Z Fmk\ ;g IN ® n 0 o E q m �■�E § k 0 i ( Zial o s C Date Rec'd 9 CITY OF PRIOR LAKE PLUMBING PERMIT v x 4fI NNES 6 ° P I. Blue File 2. Gold City PERMIT NO. /0 , 6 V 3. Yellow Applicant i (Please type or print and sign at bottom) ADDRESS ZONING (office use) 3 .\. Mea,C601 e Ctt �� LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID O (Name WNE ) R 1 a h U,..SE (Phone) (Address) APPLICANT Champion Plumbing # 61770 -PM (Name) 651- 365'134u (Phone) (Address) 3670 Dodd Rd. (Address) Eagan, MN 55123 (City) (Zip Code) (Contact Person) \( �\ (Phone) /3 , ? t _ . APPLICANT SIGNATURE f t ' DATE 1 1 IS 1 0 APPL PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Dishwasher r Floor Drain 1 Water Softener Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink _Sew ge 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 Ifr ■st $ ]W co Building Permit # The Minnesota Statutes § 326B.148 "SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ L A-C,SC ) year effective July 1, 2010, until June 30, 2011. STATE SURCHARGE $ S. �. The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $ S y .S0 is 55, beginning July 1, 2010 This Application Becomes Your Building Permit When Approved Paid Rece t No. ( ( - ri �G Building Official Date Date 1 1 1 9 11 a By , 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 (� (0(6 ��)) ^ ID �� "' 111//