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HomeMy WebLinkAboutPlumbing Permit 12. 0649 O 4. 0 000000 -0 0 x. E0 00 0 w - mT111 0 0 ) A 0 E 0 0 0 g gz z m m q �o C3 § rnm 2�E § §d z $ �� Ch % t ) 2 $ § P 2= tZi w *>0 m -1 § 2 0 2 0 Q % � � 2 q > --I V ) § § o k q z n 7 © 0 > o m m \ § § 7 . • ¢ m' 0 1:I 2 z 23 §R m m mm c -a 00000 � -0 / q z m o C M § > ) \ K ? . \ § x § m \ ® ?- 2 m§ q > 000 0 3 z m( % § 0 1 ( / %00 Xm c \ § q , 2 2 t z s m r- i% P % m / i 0 ■ ~ ; q 0 0 0 % 00000 7 - 0 Q� 3nm § ® ■ ■o ° 0 mm30 >< � . % § §M / \§ .. q • m E 2 ® - m , �§ B L.1 , r RID Date Rec'd ° � % e CITY OF PRIOR LAKE PLUMBING PERMIT dfiNNEsoo I. Blue File PERMIT NO . 2. Gold city -7 J L., gLi 3. Yellow Applicant I v I Vi (Please type or print and sign at bottom) ADDRESS ZONING (office ) c��,n Are. �G LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) APPLICANT p (Name) .. ��r✓- � P( 4- (Phone) - 1 �a - L f & 1---7 (Address) ( /2-110 rr i � �� / � -- (.....72.14.. i -- (Address) (City) (Zip Code) (Contact Person) °` +' � _/1 ti (Phone) sa '0 3 7 9 APPLICANT SIGNATURE 2 'Y`� ��i _ .. • DATE < ° APPLICANT 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 `r 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 '1st $ Building Permit # 6 The Minnesota Statutes §326B.148 q� ^} "SURCHARGE" has been extended PLUMBING PERMIT FEE $ — ('' , ° until June 30, 2013, STATE SURCHARGE $ '7 1 The minimum surcharge for a TOTAL PERMIT FEE $ 4 9 , <&- '4 "fixed fee" permit is $5.00 This Application Becomes Your Building Permit When Approved Paid Rec No. J„/ m; Date Building Official Date �' 17 . ( t-� B , (!(r 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372