HomeMy WebLinkAboutPlumbing Permit 13. 1131 — 0= n 00000 13 0 > E0
§ 0 \ 0 0 j kk , c 0 m - 0m
m0
r ■zw X m
2 N m m m 2 -oz Z @
q\ - 2 § §o�G P Zk
* > d -1 m � - m 71 / k \ 0 ` z 0 k
n m
/ 0 , r / 7 \ \
m
X, m la 13 I .
z �} \ \ \ �^ 0 00000
m mm : \ ���* c�
\ q K §§ . ` 2 E R FA §E
/ �� & I■ FA m o 0
2 2 ■» m m 0
\ \ / § § n000 0 c % m
q_ o z k 7 0 73 z r
3 a \ r
' > cc N) m
\ z a m I \ r o
X 0 i
o 0
\
§ k \ 1;400000 l
a. > k ' >xx0§ t,s,
§
% o x ∎q -0�®
<
\ y \ \ § /j}K
\ R � XI�7�� -
\� w �- E c
« 0
. •
�
\,�
PRIo Date Reed ° � CITY OF PRIOR LAKE PLUMBING PERMIT
�' :
44,vivESoi.P Biuc File !
' 2 L . cola File PERMIT NO. / 3 / a /
3. Yellow Applicant 6
(Please type or print and sign at bottom)
ADD S ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID '
OWNER - k f lOc (Phone) � �'D --- -5416 . - ?? g a
r •
(Address) 3g7 c ! ug se k, f PJ -
APPLICANT .�— /314
(Name) ektes (,0ed ?"- Cp vN'i't�sq (Phone) (>';S'—l' 72 rr e°t
(Address) -2-00 A{ci 1 JC kb - se-i%-€4.- y_l o C
. (Address) _ (City) (Zip Code)
(Contact Person) ...7-41-0 e d- R "9" (Phone) a- - 2 Z� 1 `/9L
APPLICANT SIGNATURE / DATE /0 _ lC ' 1 . 3
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 f 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
The Minnesota Statutes § 326B.148 •
- . }st $ Building Permit #
"SURCHARGE" has been changed for one
year effective PLUMBING PERMIT FEE $ -
July 1, 2010, until June 30, 20 STATE SURCHARGE $ .50
The minimu surcharge for a "fixed fee" permit TOTAL PERMIT FEE $
Is 55, beginning duly 1, 2010
This Application Becomes Your Building Permit When Approved Paid 7 l i • Rec No. 7o / /
Date U, /3 B
Building Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
O
pi\