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HomeMy WebLinkAboutPlumbing Permit 14. 0972 ■ \ _ 2I § www — 0 m 555 = 0 k k K & & wk 4 CD se 0 § 000 ■ ■ § . Z. , � OCOOOX § § ) l 7 ei 2 t aa � m k § q w d z m « z o p w 0 $ k k\ a o UJ ` Z Oe @ _ zza § § S 0 a 2fwce W2S \ \ : \ a23 § a. 2 � � § 1 000000 0 0 w % .. ` a a 2 I al ' & z 0DS rg m CU Lu o 4c U \ P 0 () 2 le Eg le E % § § § Z < I- I- w e • 2 ■ © © �kCO k ��� �� ul & CC CL -I 144 z k 0 \ ; 0a k E 0 u. u. u.§ I§ 0 g §■ 0 O £ � 2 § a 000000 U O�PR/i3� Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT ) q 44,INNEsel I.Blue File z.coPERMIT NO. f ` C � Gold city 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESSZONING office use) l (p3-7 (P \Ji cbri a✓ Ctit SC �'vD LEGAL DESCRIPTION(office use only) - 5411.14. ,—k �J^��� LOT LOCK 3 ADDITION 0140/44 Z iJ —A /V PID OWNER , (Name) K I m va n---r(ailM (Phone)5 `p??(p -4 'M (Address) ryi_,Q - APPLICANT (Name) (Phone) Appliance Connections Inc. (Address) 2850 Chesiout Blvd. (Addr f S1N 55379 (City) (Zip Code) 95 544IKY3 (Contact Person) (Phone) APPLICANT SIGNATURE DATE 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 joh cost with a$49.50 minimum Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $49.50 The Minnesota Statutes§326B.148 "SURCHARGE"has been extended ;t $ Building Permit# The minimum surcharge for a "fixed fee"permit is$5.00 PLUMBING PERMIT FEE $ STATE SURCHARGE _ TOTAL PERMIT FEE $ (Office Use Only) • This Application Becomes Your Building Permit When Approved , 1111I Receipt No. , G� By Building Official Date �� C t W 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372