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HomeMy WebLinkAboutPlumbing Permit 10. 1122 E 0 0 n 000000 - 4 0 Eo n 0 k 0 0 o � K © k § . M 0 ii 2 c m ri k r § 7/ m E *E z cn of t a w 2 "I °� �0 $ § Ti. o z 9 .. o a 7 0 0 § � k % ^ k � �� 0 :*0 k Z k \ 000000 ■ $ m m E �� a � o 41 _. z o o m e > M c % P 2 ni ti ■§ m■■ m 0. ■ \ m \ § � . k000 0 m m q q 0 Z 111) ) X222 - C C z 5 m . rla 0 m / j ` .) c A. n C 2 � 0 m DOOOO I "r % z > 0 2 - § 2 o COm o « w— \ k q 2 Fr' 4 q m �■ 2 �f 0 m 0 ......,v , PRj Date Rec'd e CITY OF PRIOR LAKE PLUMBING PERMIT 6-440 In Q i ...,,:._,!. . _ 44 NNESd / . Blue ' Gold Fl it PERMIT NO . /0 ,/ 2. Gold App // Z Z 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 3U0q 3g-cirs clwii, NW , LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID ( O Na WNER Jk &(i \ l (Phone) on 2.- -2-te - I-10 b (Address) ate 0"1 J2 cexs Q' 6 ki • N v3 C \ or �-( - APP �(�(� A . 3� 2 LIC T p(1 -�^ _ 1 _ J M / , y /� Q 2 1 � (Name) ) tA V1.i 1 . U' ).S e r5 11 . �'l�__ _ (Phone) "1 �"1 �O J I (Address) 141 O ;,4-e rS SI. 1 V E 1 r1 p1( LAVA., 3312 (Address) (City) (Zip Code) (Contact Person) IL 4k... (Phone) OC) 2 - "f 11'- /� 1 APPLICANT SIGNATURE , � �I I L l _ ^ 1 - DATE 11- 1 l q -a �dr ��-�' -/ D AP , ICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough - ins Dishwasher Water 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 I% 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 Est $ 5 00 , 00 Building Permit # "SURCHARGE" has been changed for one year effective PLUMBING PERMIT FEE $ .Duty 1, 2010, until June 30, 2011. STATE SURCHARGE $ .50 The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ P.5 4. imp is s�, beginning duly I, 21110 This Application Becomes Your Building Permit When Approved Paid,/ 3v Re ' t No. to / /go/ Da te / Bu 0 ? J.. O ildina Official Date { , ( Q 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372