Loading...
HomeMy WebLinkAboutPlumbing Permit 13. 0706 = Q 0 000000 7 0 > Kg k 0 0 0 ri* 0 u) -n z A 2 m / O 0 0 2 2 2 M > M 71 M q� \ § § k . Z § / � -4 �\ 2 t * > 2 q $ § G k 2 - > a / m ~� 2 q ( z 4 rn rn -n 0 > © i m 0 >r z f ° \ , : r o r k 02323 ' � . 000000 J f x § §) § §� §§ ;' 2 §oo . \§ I■m=s -a 0 cn k m 7 0 >000 0 m z m , 23 0; 0 rmoo @ @ r 0 • 0 o z ] ma c§ 2 m k $ P. m • d r- -a P \ 0 \ ~ = 7 /' § ` C 0 q 0 ` i 0D00D § 7 �kk�§ § R. \ ® //f > >n027 �) % 0 \ -n x -, m -IE 0 K qr 0 rRZO Date Rec'd 0 .7 � CITY OF PR IOR LAKE PLUMBING PERMIT &-t: 7 ,Ii 4r o 1. Blue File 2. Gold City PERMIT NO. /3 'J, �, 3. Yellow Applicant / / (Please type or print and sign at bottom) ADDRESS ZONING (office use) 9a(013 P t CKV)n) S S LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER " a p� �� (Name) l I ir 1 7 (Phone) 9 , (Address) L' a (.DO pi Q C& fl l SA. 3EI (Name) - P�U , (Phone) 1 C). L/ / g L/ 1J LJ / (Name) � � n.Q . �� L' C� ) � `� �w J (Address) � `I ) ��'���' ® se. , ^ ` 1 (Add re ress) A \ \ 1 ��� �( (City) � (Phone) a (Zip Code) (Contact Person) K a O CZ� Pelf() SKI( V I LI L' L/ L /L APPLICANT SIGNATURE DATE 7-i---73 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins Dishwasher 1 Water Heater Floor Drain 1 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 § 326E3.148 Thst $ 1.P °S— Building Permit # "SURCHARGE" effective has been changed for one PLUMBING PERMIT FEE $ GI S year .July 1, 2010, until June 30, 201L STATE SURCHARGE $ ) (1D The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ 59 .S0 is 55., beginning July 1, 2010 This Application Becomes Your Building Permit When Approved Paid 5 4 1 Rec g4 No. y( Building Official Date Dat °7 -13 By' /— • 24 hour notice for all inspections (952) 447-9850, fax (952) 447 -4245 ( ___,,, 4646 Dakota Street S.E., Prior Lake, Minnesota 55372