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HomeMy WebLinkAboutPlumbing Permit 15. 0273 E 00A n 000000 T. 0 a ■ n §§ ■ 0 . w o § k co 0 \ 0 ° 7 o-4rM E ■ § m ■ § m-4 mo) m ; EoEP t '4q Z2 ®§ Q ■ z § 0wnz z ■ .. % ie x c) 0 k § 0 z m nMITI m o7 0 o m200 000000 ` § m Mmm ■ .004 * ■ 'CI E -1 B D D 0 - §- 10 ■ ■ mIs - n ■ § GI m kk73 zk �k k k q o 0 x1122 ■ -1 • c § 24 FR . . r - D ■ o = _ ( ' ■❑ 0000 § Vii § R 0 © commE © or ;; ; § § 0 000 m xim ■ r g z -4r OI ?Rio Date Rec'd I., CITY OF PRIOR LAKE PLUMBING PERMIT 3 4rse is cola city PERMIT NO.`5: 2 73 3.Yellow Applicant t << (Please type or print and sign at bottom) ADDRESS arc) r ZONING(office use) C�(,P7 � ke I I a' I LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID Oavin ER Rotor\ � V�/I I (Phone)(p13 -606RY y S (Address) 1(p01 L\ eked 0014 fro (, (NaamLe)ANT `S "mt(anc, / (Phone) q53.--1 3S—214`4 9-- (Address) Ro aQ coo 1 11 —1(. n�► (Address) l (City) �' (Zip Code) (Contact Person) r ,e5 (Phone) ( 7— APPLICANT SIGNATURE �, i./ . DATE -5/(3q/1 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 Residential,Additions&Alterations $49.50 The Minnesota Statutes§326B.148 t $ Building Permit# "SURCHARGE"has been extended PLUMBING PERMIT FEE $ "T",• '0 The minimum surcharge fora STATE SURCHARGE $ "fixed fee"permit is$5.00 TOTAL PERMIT FEE $ 1-1- •50 1 This Application Becomes Your Building Permit When Approved Paid 5OF ceipt No. Buildius Official Date Date : ' y 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 111 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372