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HomeMy WebLinkAboutPlumbing Permit 14-1293 I 0 O n 000000 0 E xi C ninn n g o § o O ■ 11� -n11� § ■40 k� �c� m a k �Or XI2 $-I -/ k ZK \ k0 § m% t ©- 0 ■10K > m § 2= • z§L 02 XI > § 71 0 Z - Z 2 % m§ kk 2 m m -a -a L. Z 2 § § 41 M � m m 000000 E 2 § § �� ■$�� ƒ 0 ¢k2�%k m 0 " CO 2 m 0 2 > 090 0 ■ o m o 0 a to . 2 2 2 / / St 0 r §� o 0 m § „00 .1.. @ z OOOOQ S . Q §§ ��2 § �v C � 13 §© m> 13 / <✓t >m4 m rn -9 a. 53 .„ ■ -i� -i � t z m -4r Q • O*PRIp� Date Rec'd N CITY OF PRIOR LAKE PLUMBING PERMIT %NESOc� I. Blue File 2.GoldPERMIT NO. )� lCityp f 3 3.Yellow Applicant / I (Please type or print and sign at bottom) ADDRESS ZONING;office use) N5 ? Short crrs1- 1 )c. N. UJ LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER I r,(Name) MI qJ ( , (p ) q 2p0 (Address) i4 35 kat c rc 4 ( , (Name)APPLICANT C �;\' S X (Phone) k9 9 g" V g( , (Address) �1 0 � Dy )-k--tkoi6or) WI 5(O tb (Address) (City) (Zip Code) (Contact Person) 1\-n 341613, t Phone ()5 ) 99 y- O'7 q APPLICANT SIGNA 1111 * I ' r DATE A t t q 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 job cost with a$49.50 minimum Residential,New One&Two-Family $149.50 GO Residential,Additions&Alterations $49.50 Estimated Cost $ /00A W Building Permit# The Minnesota Statutes §3268.148 PLUMBING PERMIT FEE $ "SURCHARGE"has been extended The minimum surcharge for a STATE SURCHARGE $ "fixed fee"permit is $5.00 TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid 't No. ^ Date tit 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