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HomeMy WebLinkAboutPlumbing Permit 14. 0301 g 0D ) C) 0g0000 -0 o a En n 0 a 000 . 0 22B � 2o z m k 543� 4 § » ° xxq 3 - rrEz2 z ■ co q � tti r mm � m z � � o � ■ .0 % a. -4 -Iq IL § ®qQ P Zk 10 '4 ■ > ■ m n z 2 § ■ 1 o © Z k M n > o m m ttl o a y ■ ISN ■ m 3 x 2 0 k z xi 73 xi o o % c ❑ ❑ O m - mm Xcn * E -0 k & ~` 0 � -I05 .11 2 K f m ..a -I m o C, @ E m P, 2 > 000 0 § -I m § q U 2 k k 73 z ' r 2 2 7 r13 -a 0 m z m2 0 Q 0 ,,, ksDO ❑ 000 1 ,_c. & § ;.122mo � m >R. � ' V 'a ® i m \ i 11 5 > VJZN m 0 222 - � 4 m - , ■ E ` 2 § 0 m . pRIDate Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT gv01 p,�_YA.._SOSI. Blue File PERMIT NO. /Z _'�1YS 3 Yell App ` "i a 1 3 Yellow Applicant 1 (Please type or print and sign at bottom) ADDRESS ZONING(office use) %4045 Mai iet rd tohy LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER j�� /- r 4.73q (Name) I Lun Retiv) e (Phone) 404-599- (Address) C(rY)U APPLICANT (Name) Appliance Connections Inc. (Phone) 12350 Chestnut Blvd. (Address) (AddrS ako ee, MN &5379 ess) 952-445-4803 (City) (Zip Code) (Contact Person) (Phone) • f,� �//Z / APPLICANT SIGNATURE ��''rn��' -7�/ DATE `7` �t 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 I%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $49.50 Fetimatvd('net $ e5C,. fin Building Permit# The Minnesota Statutes§326B.148 n "SURCHARGE"has been extended LUMBING PERMIT FEE $ 419, 50 The minimum surcharge for a TATE SURCHARGE "fixed fee" permit is $5.00 'OTAL PERMIT FEE $ 50 This Application Becomes Your Building Permit When Approved Paid3-/L Re i No. (q Dates— (r (OJ___ By 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