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HomeMy WebLinkAboutPlumbing Permit 14. 1204 I OO . n 000000 > § a k �k � n kk2§ � cck m m ■ � §§ §m n� �9 73 -1 ti r§ m � z § ®§ Q P Zk ' a, § 0 ■ u) 0 z § §■ 7 k -/ Z ' 0 k n 0 m m % 0 D z> 2 • Dr_ 0 3 § m 0 73 Z 0 R 000000 x Mmm ; "0 ® ■ ; � ns2 .10 � / CO f m Q o % M ■ § z � m 0z co n 0 ` § 2kk 0 § m 42 trj Do § / § § § I. , m 0 / 1 0 . 2 n . 2 , 000OQ § D 0 > 22 § § • § V o © G 1°2 1.131 /. k zgsss j tli n 0 � m2 Pi E ) _ 0 4 C ■ -4 • 0 O R'p4 Date Rec'd it CITY OF PRIOR LAKE PLUMBING PERMIT erste Blue File Gold City PERMIT NO/ ,0v 3.Yellow Applicant (Please type or print and sign at bottom) A I ADDRESS ZO I G,:office use) C.3. 0c6/1414)94 LEGAL DESCRIPTION(office use only) LOT,3 BLOCK a– ADDITION /Y 7& � 5/ `hlee4 . PID a-.- y OWNER J � (Name) p 2 f7`�-�t (Phone) (Address) APPLICANT0 r, 446 to p�'//�/ (Name) (Phone) 01?-1 ,'4 r (Address) 51'y2 lX aS e Ave- 'y , A16,7 (/0 31 (Address) (City) (Zip Code) (Contact Person) /36 i (Phone) /) i' '- ,:iC'V 1 i APPLICANT SIGNATURE eetkt/`- 414--- DATE .._%c) -'<) --7--/y 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 The Minnesota Statutes§326B.148 Residential,Additions&Alterations $49.50 "SURCHARGE"has been extended st $ Building Permit# The minimum surcharge for a "fixed fee"permit is$5.00 PLUMBING PERMIT FEE $ 479, ea STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ � (Office Use Only) This Application Becomes Your Building Permit When Approved Paid ,J n Receipt No. 701.c--7 Buildine Official Date Date Q 17. (q By 5 j 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372