HomeMy WebLinkAboutPlumbing Permit #14-179 04 pRtp� Date Rec'd
,� CITY OF PRIOR LAKE PLUMBING PERMIT
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lease or ' t and si at bottom
ADDRESS ZONING co�t'ice use)
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LEGAL DESCRIPTION (office use oniy)
LOT BLOCK ADDITION PID
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APPLICANT " ` ) �� ���' � .] �
(Name) (Phone ` � �
(Address)
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(Address) (City) (Zip Code)
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APPLICANT SIGNATURE � DATE �' 2�D���
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Fizture u�nti T e of Fizture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laund Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
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 & Aiterations $49.50
;t $ Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE° has been extended PLUMBING PERMIT FEE $
The rninimum surcharge for a STATE SURCHARGE $ '� Q�SO
"�ixed fee°' permit is �5.0@ TOTAL PERMIT FEE $ ^
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This Application Becomes Your Building Permit When Approved Paid ! �T^, R eipt No �� (
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Buiidine Official Date Da �� ,�� r� B � 7
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24 hour aotice for all inspections (952) 447-9850, fax (952) 447-4245 �
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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