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HomeMy WebLinkAboutPlumbing Permit 15.0582 - k ■ . ■ ■ ■ Ili d / � � < % 0 « ,, q _ ° a.■ §� � 0 0 2 f o § � ■ � E z C4 ct. ❑ cOOc § § . 1Y in 0) ul H rt w d D. m k 0 2 O I- § o o -1 z d § - S k ■ 0 000 « 4 «CI c = z ■ zzz ■ u c I U 0 w ■ ■ ■ ■ mIL k U a § 0I § § 0 o o z M o \ . a � 3 � a � w w § i 000000 0 0 § % rt tx @ UJ 0 0 I i0 11.4k w I- z � \ U. 2 @ 0 ., 0 z w CO t ri ' 0 §z � � g a 2 « r(j re ; Ci U. Z - Z © 0 gzI" 2 § § § � § $ o o u2 §■ ■ § o o t a 2 0 a 000000 U O ❑ E. 01 VR1 C. Date Rec'd t-ler)t CITY OF PRIOR LAKE PLUMBING PERMIT /9- /. (3— I.Blue 2.cow city PERMIT NO.,,,,,-_------1 dS 3.Yellow Applicant d (Please type or print and sign at bottom) ADDRESS ZONING(office use) 1 ?t 3 er .6(i LEGAL DESCRIPTION(office use only) • a� AJ LOT 2—BLOCK / ADDITION cbe�®�-.� e t MW) PI]D g--- )O-1)p (ONaWNER)4 N,h m r& / (Phone)15d - W°4 -0247//Y (Address) 59v-ry\d(---- . APPLICANT Appwance Connections Inc. (Name) 11$50 Chestnut RIyd_ (Phone) Sh&*opee, MN 55379 (Address) 952-445-4503 (Address (City) (Zip Code) (Contact Person .AA/ I. .., t / 0 (Phone) :5"-C — C/c/O -• p?C/ /'' APPLICANT SIGNATURE IJ!Pi_ 1 ' '" ' . DATE 1� APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher I 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 joh cost with a$49.50 minimum Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $49.50 Estimated Cost $ Building Permit# i ne lvtinnesota statutes<t 6Gbts.1.11.0 PLUMBING PERMIT FEE $ �.� "SURCHARGE"has been extended STATE SURCHARGE $ =�r1� The minimum surcharge for a TOTAL PERMIT FEE $ — "fixed fee"permit is$5.00 (Office Use Only) -9 This Application Becomes Your Building Permit When Approved !'it .s r o Receipt No. 5-2, 3 .. - By Bnildins Official Date y moo, 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372