Loading...
HomeMy WebLinkAboutPlumbing Permit 13. 1207 g 0 O le 0 00000 - 0 0> ■o 2 <. o 0 2 ' : .� A E q � c kkk Z � � \ % ,� M M 3 —r1-3Z te co M 0 m -o Co =I %� q q - m 0 ©qQ P �k 1, 0 s % § N 51 - Z 0 / k \ \. . $§ Z 0 m oi 2 } 0 7 ` z � o -o . I . %, z \ R / 000000 M M > ■r ■ s1 E ° 0 \ 0 -1 $ 2 f ' ƒ$ � � 7 � � ` § r> - §k � qM ■ k ® § :\ Icc r 2 R m r 17 -a P ∎ § / _ '. 8 0 * V. 0 \ . 2 000000 \ § 2 z St e % / -niin Z 1% 0 7 - � 0 2 M A k , ri ; ; / k \k N 0 »2 § m q�■ 2 _I § 0 . � 0 1 4Rtt) Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT /d Z9 /3 4111110 v r ■ 0 4r 1. Blue File 2. cow City PERMIT NO. /3 / 2_07 3. Yellow Applicant lease or print and sign at bottom) ADDRESS � ZONING (office use) / /' b P i p s (,,J or') J 54 - .1 - LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID ((Name) k - I y ti /"1( ) ri/s 4 , -1 (Phone) (Address) APPLICANT . , (Name) �, r IYi N\ ; k----"' v f "/"\ _ r `\(---, (Phone) `;> C `7-- C¢ ��`, L/D 37 (Address) 7- 0 1 ( E �� \- "\• c^ k. A - re / Fl d `- s `7 7 (Address) (City) (Zip Code) (Contact Person) -- , y7 j l (Phone) /-5l — APPLICANT SIGNATURE .% _,,. DATE /.%)- 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 )r- 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 The Minnesota Statutes § 326B.148 FEE SCHEDULE "SURCHARGE" has been extended of job cost with a $49.50 minimum Residential, New One & Two - Family $149.50 The minimum surcharge for a Residential, Additions & Alterations $49.50 "fixed fee" permit is $5.00 ,t $ Building Permit # PLUMBING PERMIT FEE $ Y. STATE SURCHARGE $ 5 et) ir TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid 51 L 73 Recei No. 6344 Buildine Official Date Date O . 2 1 /3 By ' 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372