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HomeMy WebLinkAboutPlumbing Permit 14-1369 5 00 t 0 000000 -0 0 > EO 2 I I . o ® ��� oo 73 2 c xl xi co i Bek- 0E I k k� » . 2 Qom ® z■ 0 % ■ § U) 0 2 z „ q ■ � § a — § § 0 2 2 °k '-13 r 0 7 m 2 r o 2 -n0 X X % Z 2 0 0 . 0000 ❑ 0 •J X § 2q ■ 13 ■ * ■ m E cn n � 2 � 0C § { m ƒ \ X a•� � �� � 0 j ) rn q _ / Z r -n § § ■ z 0 O § $ q , r � 'a P \ § I ° I m c 0 . f m . OOOo e § z § • -n �§ mak_ R. 0 © § � � � �� , 43 0 _ 00 - a § m ' � ■ r 2 Wit -Cn Z m .'. "1r 0 YRtp� Dates Rec'd 01 N CITY OF PRIOR LAKE PLUMBING PERMIT v 4tiftEs°�� 2.I.Blue Fiill PERMIT NO. I Gold C 3. Yellow Applicant i I (Please type or print and sign at bottom) ADDRESS ZONING i:ottice use) 1 Vi) U -\.'Dt klA,t,'\ :ii -- nV C.,__. LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID (Name)OWNE �� � ` (Phone) 1, a- u n LI i 05 (Address) lVP, VM-1 tA,\U `�� C' - VA L\ \\L 5 3 3 APPLICANT (Name) CV4 1 A V (Phone) t l„�L� l-L (Address) LIDit% 'J4V__- \ 11)\ -1 0 I� (Address) (City) (Zip Code) (Contact Person) _ _ (Phone) APPLICANT SIGNATURE i /Ap/> DATE laitaaql 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 $ Building Permit# i ne Minnesota statutes g 5Zbli.l.zib "SURCHARGE"has been extended PLUMBING PERMIT FEE $ The minimum surcharge for a STATE SURCHARGE $ TOTAL PERMIT FEE $ .1,�/ _5.D-2' "fixed fee"permit is$5.00 (Office Use Only) This Application Becomes Your Building Permit When Approved Paideceipt No. �� 1 Buildine Official Date Da 17 41 ' k 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 I 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372