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HomeMy WebLinkAboutPlumbing Permit 12. 0879 E g n 000000 o a E k 0 n 0 cn -n 2 -n 03 0 2 0 � � 0 2 m § � E k 2 m m 0 q k 0 0 , m z 5. 2° z ® B 1) tri § § ¢ 2 2 § ®q® o § 2 . § 0 z 2 § H o n m \ ' / § 0 > m \ \ 0 \ z 2 x ® -n / / § ,0 0 \ 000000 K k m �� ® * © r o q z § § OE -10E cn q ®'\ = MX � 0 0 m k $ � ' > / 5000 E 2 -1 • rn 2 m a x rmoo @ g 9 § 2 2 c c 2 / k 2 4 q . ��� ° . % : / m . K x � n --- \ 2 . N ° 000000 � � o \ z § 2]§ §§ ‘ ` ® J Q E M -u - .� AP \.\\ \ 0 a - I ® 0 � mm w r y� ) m w t- E m -1 r 0 .\ Date Rec'd 4 � O +P CITY OF PRIOR LAKE PLUMBING PERMIT 4. 0 l r :` ' PERMIT NO. / L_ O. .{�� 3 Yellow App '`n'NRS�� 3 Yellow APP licant ZONING (office use) • lease j or .t and ai;• at bottom ADDRESS � 011 \I � � 1 i . f tiM LEGAL DESCRIPTION (office use only) PTO LOT BLOCK ADDITION (Phone) OWNER (Name) (Address) APPLIC o _ ' ` / (Phone) 1 n (Name) '` ' � i� N' �'�� �� C Code •Y Y t-, Cl (Zip Code) (Address) 1 S it (City) (Ads I Z - `1 � 1 • � � 3 (Phone) (Contact Person) 1J • � 2-_____9 � 2- APPLICANT SIGNATURE �lJyl E Ol '�a.A.4∎ -ttitt.- DATE APPLICANT PLEASE COMPLETE BELOW T j, e of Picture 1 INIIIIIIIIII nand Ale of Fixture , Roush -ins Bath Tub with or without shower INIIIIIIINIII Dishwasher IIIIIIIIIII -_ Floor Drain Water Softener IIIIINIIIIIIIIII Stand P a ashin Machine Lavato t athroom Sink Sewa:e Vector Laura% Tra 1 or 2 com • artment sink Sewa:e Assembl Shower Stall —. Backflow Assembl Test �- 111111111111111111 Lawn S •rinkler Bar Sink Other 111111111111111111 Water Closet Toilet FEE SCHEDULE Residential, New One & Two -Family $149.50 Industrial, Commercial & Multi- family 1% of job cost with a $49.50 minimum Residential, New One &Alterations $49.. 0 Building Permit # The Minnesota Statutes § 326B.148 T FEE $ "SURCHARGE" has been changed for one year effective $ PLUMBING PERMI i✓ •—�� July 1, 2010, until June 30, 2011. STATE StJRCgARG The minimum surcharge for a "fixed fee" permit • TOTAL pERNIIT FEE is $4, beginning July 1, 2010 Receipt No. / z42.... • Application Becomes Your Building Permit When Approved Paid gi/ ,..6--6 !r This pP Date / By / Date Building Official (952) 447 24 hour notice for all inspections (952) 447-9850, 55372 4646 Dakota Street S.E., Prior Lake, Minnesota