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HomeMy WebLinkAboutPlumbing Permit 15. 0558 E 0O 2 © otyl O �� �222 K � n 0 g o . z o & o 5 k rt ? k ,3 x s TPFEEk T m m omo tn % 1 -1 _1k Z V 361§ 0 P 2z X • Z 0 r/ t m o mm md r o - o % m li ■ 0 0 000000 * i 0 -4 Zmm mrM > mr 7 _ » m ii xQ mx& . 2 M ƒ 0 N. MI ■ ■ M § m o 0 m R § ' KB8§ 0 E m tli 0 o z rii §o o o � k�o mQ. V. z 0 13 0 . \/(103 OOoO Li � 22� �§/ k �_/� � � � -- R. \ 0 _ � 0 ■ mm -Ig � :-.1 -1 0 m .. -1 r Q 4pRIo 0/ Date Rec'd etCITY OF PRIOR LAKE PLUMBING PERMIT 41.414100 . Blue File .cola City PERMIT NO. /c615- -- 1 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 1 7i/ Lytes 3 553'7 a �L 5,6 LEGAL DESCRIPTION(office use only) c0/72/� LOT BLOCK L' ADDITION 20c0g4a Pvjo,Q - ^� PID -036, co OWNS: s , t(;� -T`� Q5a-441-0 90 9 (Name) IC AL/ (r 4 t t C (Phone) (Address)/(Dl`l L ya'i s Ave, c� 5 531 APPLICANT l (Name) A 1011.042,1t_ (IOW C17 014S (Phone) 95a- 4 4 5- 4803 (Address) Jn5O eAL s ?7 -- Pivot shakcpa 6537 (Address) �/J (City) (Zip Code) (Contact Person) JQ41d21/Q J K,-toAel (Phone) 95; -44 5-4803 APPLICANT SIGNATURE L. .$.I2_,/ DATE .4Jr 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 Estimated Cost $ 6,06: 0 0 Building Permit# The Minnesota Statutes§326B.148 "SURCHARGE"has been extended PLUMBING PERMIT FEE $ g ) STATE SURCHARGE $ 0,14The minimum surcharge for a - TOTAL PERMIT FEE $ "46 "fixed fee"permit is$5.00 (Office Use Only) i al' This Application Becomes Your Building Permit When Approved In id Receipt No. i Kiro C 1 lialrialli, ByBulldinr:Official Date Z 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 I 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372