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HomeMy WebLinkAboutPlumbing Permit 15-0013 = 0c n 000000 "0 0 > E 2 § § § 0 ® ZB � oo z rn k 43�4 E Jr � co m th hi r mm m z Cl)k � kz \-0 % t � q -I m 0 - Z o t2 g » ■ 03 © z 0 §0 n [ . , j o Mm § 2 MB r z 7 I�� r o x '0 -o % m 2 0 0 0000 ❑ 0 Z m (I E M -, �� > ® 0 ® M m tg n 0 o _ r m iu o m tri 0 § m z re Cm z 2 m i P k 73 o _ 2 m L c k \ O ❑ OOQ r ti / 0 g t o ® F00E0� � � )Z § M 0 � » mm % � I § m 22� § ■ j -1r 0 « 01 PRTp Date Rec'd ot CITY OF PRIOR LAKE PLUMBING PERMIT Er ' ,'' i '-:.-- 1V ESO* t.Blue File 2.Gold City PERMIT NO _C7 0/3 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESSZONING(office use) 1U --4-(-1 - 1 < \OC,rdsi- Nrk\).;Q. LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PIDp7-'o)-1i -OWNE � (Name) "1 QC) A ' V S (Phone) "1 ► ) 2- L'9lQ-(Address) 1 U 671— i' — \ w3 s-✓ a ''-S V OV DY L o V ON 3 APPLICANT k i , ( `,� �� i - (Name) ` U. U . A (Phone) e� 4 (Address) Liao - k vwy ck 10 ink A VV . �59 (Address) (City) (Zip Code) (Contact Person) Li J I `l�G ` cihone) on q - `ILO - (4---4 APPLICANT SIGNAT ' ' ig.20-4\L,aot61:S11(DATE t L/0— AP ICANT PLEASE COMPLETE BELOW Quantity Type of 'xture 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 00 The Minnesota Statutes$326B.148 w est $j___q,D------- Building Permit# • "SURCHARGE"has been changed for oneO year effective PLUMBING PERMIT FEE $ 'one ( )0-2.._ 1,2010,until June 30,2011. STATE SURCHARGE $ `J l",2iEl The minimum surcharge fora"fixed fee"permit TOTAL PERMIT FEE $ is L,beginning July 1,2010 This Application Becomes Your Building Permit When Approved Paid\j 75(3 Receipt No. q/f7 Date //e/LC / /LBy �� Buildins Official Date ! // C �. 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372