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HomeMy WebLinkAboutPlumbing Permit 11. 0099 E 0 0 0 0 000000 0> E n n k xi 73 73 K . m § / Z m 0 � cz, 73 to r 71 hi r 0 0 M 2� §§§2 0 k �NI • t t -I-4 q z m a 0 k ro 4, K 0 u)© z 2 §■ CZ 4, § ;12 �� 0 Z k © ' 0 0 m F: % F o `6 6 .11 - a � MZ 2 7§ . 000000 • m m m ■i) ■ ■ ■1, o C n a mr l > $ \ K ? -n � ■ §a§ m O 0 *, m 2 q zZXX § 2 z p X § q r2 2 2 — o C § Z . m r -0 -o § § c). a 0 �� . § m / ` & 2 n a . P 2 0000OO ` , � ._ k � § § o 11 11 - 0 0 cm 0 * C /mmz tJ m •■ ■ � F 2 a E m —1 r 0 C 0 Q / Date Rec'd J , CITY OF PRIOR LAKE PLUMBING PERMIT * '. Gl F it PERMIT NO. q 2. o Y Ap `/ �/ 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) ( q COGC,hr re r) COIN 0 G LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER ` / � 1 ?01 3 ? O ' (Name) V e L n 1 (Phone) Ot (Address) / L q CO a m 1 .,,VC` 1J PrIrr tCa(R, y /u r (N ame) AN' �v`,^) PI u rn, ��- "L (Phone) qCov V VS 7 V tf (Address) l 4 W ` ---.1 1/W''1' —e_ . SS y� ,. (Address) (City) (Zip Code) (Contact Person) 1` '�✓ k. Sol t w b , Po4Y) AlL► , 'hone) q 7 (� r 9 L ` 1 Lf APPLICANT SIGNATURE DATE APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins Dishwasher l 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 Sprinlder 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 1 C.A.- The Minnesota Statutes § 326B.148 Mg $ / .a� Building Permit # "SURCHARGE" has been changed for one year effective PLUMBING PERMIT FEE $ 't 9, .5 .July 1, 2010, until June 30, 2011. STATE SURCHARGE $ C-1-250 The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ S 9S b is, 51 beginning .July 1, 2010 This Application Becomes Your Building Permit When Approved Paid _ -7 Rec No. 6 02_66y Date / / B / Buildina Official Date . rs ` 24 hour notice for all inspections (952) 447-9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372