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HomeMy WebLinkAboutPlumbing Permit 13. 0654 L u » ? Z§ Uj $ _ j e�� : 0 \ § z > 111 , » O 0 7 \ I-. J wo ��� . © ! 0000O \ § co w 0 1 (.,), ct u. N \ § a z § 0 . - § 0 \ 0 \ 1 - : b E2 o o 0 0 w $ - ??$ƒ 3� \ / Cl- / 4 0 0 w m W p m z o n - §§I w iw x 0 c e _j 11.1 0 0 a. W 000000 ® i I ° U o g a 0 < 0. E § v 0 2 \ S = � 3 ƒ $ @ § 2 z § - { 7 a k § / 2 R % W z z o < Z \ Z § § § § j w < � a b Z 0 9 9 \ } j 2 w \ \ o Q or- w o0 / o o u.u. @ u. § 0 n e O . 5z « 0 a 000000 U ( c ", -- par p Date Rec'd I 4' CTY OF PRIOR LAKE PLUMBING PERMIT NvivESO /1 �p I_ Blue File I Z. Gold city PERMIT NO. _ Q 6 3 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) J6l � I C) 5 e M 0 L Sk SS ) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) DO V.q l 1 ''\ �� p ` � r -�-a -� (Phone) 93 a - `1 C f -1 ) Li (Address) 1 / APPLICANT (Name) CULLIGAN WATER CONDITIONING (Phone) i l 6 CULLIGAN WAY ill" � (Address) I/ ► ► 1111,•1 u (Addl(0 ) 933 -7200 (City) (Zip Code) (Contact Person) \ (Phone) APPLICANT SIGNATURE DATE L - 1.3 - LI 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 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 )st $ e _ 0 (), 00 Building Permit # The Minnesota Statutes § 326B.148 "SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ 'i9.5 o year effective STATE SURCHARGE $ .5, 00 3e' July 1, 2010, until June 30, 2011. TOTAL PERMIT FEE $ , Sj N , 50 The minimum surcharge fora "fixed fee" permit is $5, beginning July 1, 2010 This Application Becomes Your Building Permit When Approved Paid 4 p / �-- Receipt No. • 934 Building Official Date Date i Achi By 24 hour notice for all inspections (952) 447 -9850, fax (952) 447-4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372