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HomeMy WebLinkAboutPlumbing Permit 14. 0774 C) 000000 1 0 a ■ g J 0 OX O ■ 2! " " § 0 § �1 oo z m ■ mo n n 0 kkk m xpE02z 0 ca k\ k r 0 Ca ) ' k z -. -© . z- C z z 0 /S. i q } 2 z 0x k 00 - mm rri t r 73 r % \ 2 -I 222 . 000000 -a � � mm 2 c Itmr cmc o z § § f m ■Emxs -0 n % cn ? 0 P ii § 7771§ ' 0 C) % e -I > 00 C § m 2 G q r -no§ f 't q / z ikc m , z : cri \ P g �,, 1 r / § ! O0000 k _ $ o � � n § t ' Q $ v�commz© - » 00 < m \\-' o — 41 z . >FA® 47 q F1 4 zri -4r 0 V Date Rec'd aOt?Rt'04 I- CITY OF PRIOR LAKE PLUMBING PERMIT `7 /4 I-01 d0�� t.Blue Fite 2.:d City PERMIT NO. /4/, 7'7LZ 3.Yellow Applicant / I (Please type or print and sign at bottom) ADDRESS ZONING(office use) H IlL Coyok C6,-cl 5337 S/ LEGAL DESCRIPTION(office use only) l ,� � 3.--; LOT/v BLOCK ADDITION G,1 ©4)44 PID R✓" Vol/ OWNERt( (Name) -T S 0 vx Q...1,5 (-0,4._ (Phone) (ala -39$ -4 3 S I (Address) J APPLICANT (Name) (Phone) c: LL-11781 WATER CONDITION)J I+f (Address) 6030 CULLIGAN WAY AlAkalgONKA, MN 55345 (City) (Zip Code) 952) 933-7Q0 (Contact Person) (Phone) 1 APPLICANT SIGNATURE _1 B , DATE 1 - 0)4 - 11 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 1 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 Estimated Cost $ a DO. 0 0 Building Permit# The Minnesota Statutes§326B.148 "SURCHARGE"has been extended PLUMBING PERMIT FEE $ The minimum surcharge for a STATE SURCHARGE $ TOTAL PERMIT FEE $ "fixed fee"permit is$5.00 (Office Use Only) This Application Becomes Your Building Permit When Approved i„,;",- 6,,\,,,,-0 Receipt No.IC qvgDate (4 ' j, By Bn i I `e Official Date 6 • `'� 4°t 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street SI.,Prior Lake,Minnesota 55372