HomeMy WebLinkAboutPlumbing Permit 13.0887 C
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4, as CITY OF P ' O R LAKE PLUMBING FERMIT
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hied FCity itr PERMIT NO / 3-007
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ADDRESS ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
( R k,"00.101 1 (Phone) i ` z/ 7- l� / y 4
(Address) 1 ) 144, - c, 1 4U ---a s e_,''- j j
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(Name) (Phone)
(Address) 1 ? 1LS 7 L e (e 'uTer ) .56 � 7�
(Address) i (City) C � (Zip Code)
(Contact Person) b ) _ N v ^-7
(Phone) , — ! ✓ - -`226
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APPLICANT SIGNAT • ¢ 1. i \, t • DA'I'E ■ 1 l
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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
The Minnesota Statutes § 326B.148 ist $ Building Permit #
"SURCHARGE" has been changed for one p
year effective PLUMBING PERMIT FEB $ �'D ' , "1 , 0 °
July 1, 20'; 0, until June 30, 2011. STATE SURCHARGE $ r.50
The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $
is 5s beginning July l, 2010
This Application Becomes Your Building Permit When Approved Paid 3 - 6 / 5 0 Recei o. / /'g
Date
Baildine Official Date � t /� /� By
24 hour notice for all inspections (952) 44'7 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372