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HomeMy WebLinkAboutPlumbing Permit 15. 0262 E 0 O\ n 000000 ; 0 > gc.) C) n \ 0 0 0 0 g20� § 8 g m § �/ k r § m � � ›§ § § m mo k � 1 t �° �oqQ p �� ? & g� © k 0 0 z 2 z , Me 7 0 n o l$ gR % § x. 0 ® m � r § 7 % m k 0 0 000000 41 X MI � CTo ■ * ■ " > § o o nc enc z ? z § m x s n ■ $ 2 rn \ > 090 0 3 d ( m q J 0 Z r n 0 0 xi 2 § § z § m r '0m P m r..) -n V z 73m o 0 Cil k 0 0000 ) ks § Ai� m§ �\ § mmk (NI 41 i E - o m nnF§ m zmm 2 CO 2 m -1r Q 4 ?Ri Date Rec'd N CITY OF PRIOR LAKE PLUMBING PERMIT 3 - 0, S v .Bhu File PERMIT NO. .Yell App 3.Yellow Applicant ✓✓ (Please type or print and sign at bottom) ADDRESS ZONING(office use) / " 84 84"/f LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID (Name)OamR O4t.(/ t 4 (Phone) Qr-1-" v/7- 474°2' (Address) )')e9 ,ce,v,4,7 APPLIC(Name)ANT �Jt7 l C ''K_ �to (Phone) Al----00:f----- (Address) 52 K'2aka& /A-1 it. Aio,c- 'f'')1 , S3-77;,-, (Address) (City) (Zip Code) (Contact Person) &�" (Phone) APPLICANT SIGNATURE '/ J tel _ DATE -'.3(lJ1-r--- 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 1/4/ 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 joh cost with a$49.50 minimum Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $49.50 The Minnesota Statutes§326B.148 $ Building Permit# SURCHARGE has been extended The minimum surcharge for a LUMBING PERMIT FEE $ yl- fro' TATE SURCHARGE $ .50 "fixed fee"permit is$5.00 'OTAL PERMIT FEE $ . ' ST This Application Becomes Your Building Permit When Approved Paid - Recd i No óg Dates 3 t ,, 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