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HomeMy WebLinkAboutPlumbing Permit 14. 0266 p o o § o o n O 0000 w o b a o 7300 0 ■ � � � � § $ o K� % 3 ..F0 .9. z t 2 ,„7 m � �2222 z rn ?131 -4rn,1 itFiii o m X m 0 2 2 ' % § 7 R k c Jx m 2 000000 $ 2 f } � � Tri>mr 0 litq -o (---d Z I§ § 7§ ° 2 Es 0 o . ,- §§ o m m ¢ 0 I ® m 2 J DOOQ , \ fr1IuI ? F.,4V ■ O PRtp4 Date Rec'd 1±7Z.4)0 CITY OF PRIOR LAKE PLUMBING PERMIT [4 I.Blue it City 2.Gold CiPERMIT NO 24 w 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) J 6 70 3 t s©r st LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION pu) OWNER (Name) 3.--`1-S�✓c. �-{•.t sc-, (Phone) (Address) /6 -7 O 3 W 8 ,,- L S� APPLICANT (Name) Vo z ✓� 191(...)/21.191(...)/21.5 1'l C. o (Phone) C(2 L 7d' 6 8 7 Z- (Address) (Address) ( O • co !2 s 7 Peri( (_4 / szs,7. (Address) (City) (Zip Code) (Contact Person) (Phone) 612 -- Z APPLICANT SIGNATURE _ DATE el-4-C- /-' 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 )st $ Building Permit# The Minnesota Statutes§326B.148 "SURCHARGE"has been extended PLUMBING PERMIT FEE $ `Z f"S1 The minimum surcharge for a STATE SURCHARGE $ .50 "fixed fee"permit is$5.00 TOTAL PERMIT FEE $ S—CD This Application Becomes Your Building Permit When Approved Paid .. (t Rec p o. 7 // 7 Date/L- � / B Building Official Date ``TT f 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372