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HomeMy WebLinkAboutPlumbing Permit 14-1396 5 0O n 000000 '0 0 > $ o ggg cz n 0 © 720 0 mzckkk z m m n/ m ■ m § » o I 111 r 2 § 0� . � Zk FIH �� ( Jz 0 0 , 1i m 2 00 OcoccO § X q m m ft . . ■ "a ■ * ■ "o 2 § ° OC -10Cmxc � .. § 1.1 m f m z - xx . z 0 C 3 2 > m § 0 U g Z 2 k - / 2 R. m rT11, P m X kc 0 i gi X 0 0 0 0 0 , . z . ilmn§ , s ©ct 0 � � �� � -. © q in .x -n7 ) ° -4 E § �§ § § O PRto4 Date Rec'd Zi CITY OF PRIOR LAKE PLUMBING PERMIT v ,.GolBlud File PERMIT NO. �� s.cola City / 3.Yellow Applicant I (Please type or print and sign at bottom) ADDRESS ZONING;office use) S'.3 } -,6/,ewood I)tt. N LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNE (Name) '1 1 la-irS 5+1 (Phone) I' c9-403-7aU0 (Address) APPLICANT (Name) Appliance Connections Inc. (Phone) (Address) 12850 Chestnut Blvd. (kcINk ec, MN 55372 - -4803 (City) (Zip Code) (Contact Person) V G[�l�'1-[=IL � (Phone) APPLICANT SIGNATURE det.,r}1.1—ed `t 9;4424a DATE /2-23—/4 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 joh cost with a$49.50 minimum Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $49.50 Estimated Cost $400.0 e, Building Permit# The Minnesota Statutes§32t B.148 PLUMB "SURCHARGE"has been extended ING PERMIT FEE $ STATE SURCHARGE The minimum surcharge for a $ TOTAL PERMIT FEE $ .5'44 SD "fixed fee"permit is$5.00 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No.0 Date 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