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HomeMy WebLinkAboutPlumbing Permit 13. 1256 £ 0 O 0 000000 0 > E n ® n n O ■ ����� § & 8 � � § n 7 00 . c q■ ■ ;co m m m §o % / k k m � g 1 --a 111 , � } 0 § � � � � �k n 0 z 2 \ § % } .% B § �� k ■ m m 2 ƒ % N. 7 I ` \. § I o z x I m °o o 000000 \v 0 \ z 0 0 � § § 0 B f § ■� %§ 2 . \ n § k m - q >0 0§ - . m \N \ / Z k z§2 ` 2 k § ` . �� a x x 73 m 2 0 ` A '. i -vO ❑OOQ ����� k 1 Z § iiTi a -1 E 2 \'�I z m � 0 Ci . k. \., YRIO+P Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT /' / /3 I. sloe Flit P ERMIT NO . /� 3 . Yel City /J ' f 2 1 3. Yellow Applicant � U (Please type oil print and sign at bottom ADDRESS ZONING (office use) ,a 834 8obca ' 7r NW LEGAL DESCRIPTION (office use only) c JJ C LOT BLOCK ) ADDITION J - 11-11 Z-4-5 52 t� Y/ PID o?5' ?' 2 - �D -19 OWNER-- f (� ( Name) lX�,W ©e B f.t.hQlfl (Phone) 4 15Q-454- 964 S (Address) S&rr € APPLICANT (Name) Connections Inc. (Phone) 12850 Chestnut Blvd. (Address) Shakopee, MN 55379 (Addres952.445 -4803 (City) (Zip Code) (Contact Person) (Phone) APPLICAfvT SIGNATURE Jt4?l te. c # i / DATE / / `1 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 The Minnesota Statutes § 326B.148 0 of job cost with a $49.50 minimum Residential, New One & Two - Family $149.50 "SURCHARGE" has been extended Residential, Additions & Alterations $49.50 The minimum surcharge for a st $ Building Permit # "fixed fee" permit is $5.00 PLUMBING PERMIT FEE $ ,S�• 00 STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid rte, Receipt No. z Date Building Official Date 1 / 17 / By 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 f'fz.: ?£'r''ggA -- k ___ - '---' ----\\ j--.---i'-----"---------'r-\- r/ I ( \ Y • . , 1---- - ---- - _ _ ,,, ____ _-- �- - __ ____ ,... ___ (--___- ___ _.._____ g t 1