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HomeMy WebLinkAboutPlumbing Permit 15. 0263 J 00 0 000000 U 0 g § _ n n m z 2 2` . E r VA 8 8 z m A § � co m � 0 § R 0 0m m ■ � E' o ■ z ■ d -a hi hil r n n ■ Z $ -Q G) P 0 7 hi t 0 ° § @ § 41 q b 0 m 0 § § ZMm % N Ox 2 » z ■ F 0 3 U m k � � 000000 0 -I § m m oi EMM * Em o z o Q , nc mri > mc \ ƒ I xzxx � z 73 \ x � § � § § l r 0 § § CO . 1- 17 11 P m 2 ■ o ■ } [0 m ,"i C nm . � P.40000 mR.R. / xi 0 P ' § i3i0 §2 © . . Em -om � \ D. • > mm M 4 & � � - ' � � m -Ir 0 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT 3, 26 ,lS I.Blue File /3'1�� G z.cola ;t,. PERMIT NO. 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) r 7 (5-ax/-`7y 4L-W4 LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) PPPLLIeCANT <3 0 3 �A�`'" SI/�-S (Phone) 6 [ Z . d tD 0 (Address) Z ct Z 0.,(A.� Q /I-ye/ /VUR mpfr (Address) (City) (Zip Cpde) (Contact Person) �� (Phone) APPLICANT SIGNATURE P-01-4 '1 DATE ,3_ 3 O `11 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 Building Permit# "SURCHARGE"has been extended , The minimum surcharge for a LUMBING PERMIT FEE $ Y924 "fixed fee"permit is$5.00 TATE SURCHARGE $ .S .50 'OTAL PERMIT FEE $ y 7`Sv This Application Becomes Your Building Permit When Approved Paid.,` R pt No.99e Date3, 3o_ 0' Buntline Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372