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HomeMy WebLinkAboutPlumbing Permit 14. 0888 E O O $ I nOin2z- 222oxo a n gn kx 3 mAcsik m § o� * r \ \ a 2 §tTi % Bk0 P co 0x 10 § 0 0 U) 0 2 § z B , 03 X ; z q z % o § 1. © (p m m § r § 7 % m k k k Ab,�, o0OCOO m m m 2 k § 0 § PC- �� �tm2 $ § K f -n ,§77E� m O n , \ m % j Izx § �§ 3 z \ m r � §§ xl ri p ' c en z / m rTI -0 o , m X o , ` ' X 2 § 0 Q, ___-- *-1 �_ m p0 00 0 0 ' z m 1 E. / k . w�M3© m 0 ■ NI z m \\ � § 4 P » mm ' sm ■ § z m -1r 0 C/ W0Date Rec'd g01 CITY OF PRIOR LAKE PLUMBING PERMIT ,J /'"•xLs�� 1.Blue File PERMIT NO.i / Q Yell App / 7 J( 3.Yellow Applicant _/ 0 (Please type or print and sign at bottom) ADDRESS ZONING(office use) 11P7-J-4 r\01 C J DK. LEGAL DESCRIPTION(office use only) LOT BLOCI CqprillA ADDITION / 'c G /lfrA OWNE ((Name) "beir t ( CVA (Phone) r'(6 2- 855" 9 l (Address) I i 2Si &r Ky t 1:)P- APPLICANT (Name) Appliance Connections Inc. (Phone) 12850 Chestnut Blvd. (Address) Sh; ose , MN 55379 N45-4803 (City) (Zip Code) (Contact Person) 5C1.14C t%pc,J (Phone) APPLICANT SIGNATURE l:it.l t DATE ,PPLICANT 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 t $ Building Permit# The minimum surcharge for a "fixed fee"permit is$5.00 PLUMBING PERMIT FEE $ STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approvedid 64 50 Receipt N(1,7 j zr DateB Building Official Date 1,47-S-1 k y -� 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372