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HomeMy WebLinkAboutPlumbing Permit 15-0018 = O O • n O OQOO X 0 0 § n 2 § § o . 2 ® §moo z k � � 2 g o ■ s , KEz ° z ■ § -@ % r m m0 m § \■ § ■ o ® o. / % � § m o z �z � 0� n .. ] o q § 7 22 § dk \ o / § III ( r 0 ` i' if -n '0 '0 rn2 § § 000000 x § 2 q sr � * ® r \ � � CI k� § � §_ 1 m....0 O § 2 � i \ ' > OQO 0 § m , )13*a \ o r � §k o § m P , § � P / Xx . ..m a 0 « 0000 = 0 2 2 Qmiln§ et § 730 R. v 0 k §mE © - \ z /_ ooh , �� § F1 -n7 r � 2 � $ - , _ -Ir 0 . 0 • �4?11/04, . • Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT - v i.cc a niy PERMIT NO. J (Please type or print and sign at bottom) 3.Yellow Applicant /�- ADDRESS ZONING(office use) 544-4- Deer-F1e(CI Circle 5E. LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) Wi(soi~ A Octer5OPA (Phone) 952 226 1646 (Address) 541-4- Deer-Field Circle S.E. "Pricy LctL&, MN 55 372, 1 APPLICANT (Name) l�ra trp v k, i ti cI '_ u C, (Phone) qJ`�Z to G��f Q _ (Address) 86 15 20°"t-`% 31 . (A) La,tce,v i ((e .55044- _ (Address) (City) (Zip Code) (Contact Person) ----rri,5:jR5 2 tib Q 69 9 (Phone) APPLICANT SIGNATU9 ' 4114 -0. _/111.- DATE ( Z'2 2` 14 --j APDL ,T PLEASE COMPLETE BELOW Quantity Type of Fixture QuantityType of Fixture I Bath Tub with or without shower I Rough-ins Dishwasher _ I Water Heater Floor Drain Water Softener T Lavatory(Bathroom Sink) _ Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly ____1 Sinks Backflow Assembly Test _ Bar Sink Lawn Sprinkler Water Closet(Toilet) _ . Other . __ FEE SCHEDULE The!Minnesota Statutes§326-1I.1.48 job cost with a$49.50 minimum Residential,New One&Two-Family $149.50 "SURCHARGE has been extended - . Residential,Additions&Alterations $49.50 The minimum surcharge for a "fixed fee"permit is$5.00 $ Building Permit# •PLUMBING PERMIT FEE $ 41,50 STATE SURCHARGE $ XXX 5,00 TOTAL PERMIT FEE $ 54.50 (Office Use Only) • This Application Becomes Your Building Permit When Approved Paid 4e 57.) I Receipt No. 7�-17 i• � Bulidine UrticlalDate /, �. /.� l By - —1 nate 24 hour notice for all inspections(952)447-9850,fax(9S2)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 •