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HomeMy WebLinkAboutPlumbing Permit 14. 0775 ir 0 0 * n 000000 U 0 > � n 2 0 k0 0 0 gz0, � oo © m m �� 1,1 F ' mrn ^ s mgcEz - m § m 00 / / k Z 3B/B P o \ ■ K q k ' - 2 § , Z a @ 7 0 0 0 ` z 0 k r z x m m r o a. o z �� L' z xi 0R mm 000000 E m B m m �f mom ® > mr § % f . x m z 1, n Co , CA 3, fl 11 _ 73 ■ 23 ■ % o B 0 r- 0 ) 0 4 FA >cc _ r / t 0 r1° ') R j m o Q m . _ I oE 0 00000 i . > vO § comm , � m A > Fri -n r �� 0 ■ O�PR/04 Date Rec'd 0 CITY OF PRIOR LAKE PLUMBING PERMIT ,G/l //� v 7 ��S � � '"` F"` PERMIT NO. �Y�,, ////� �J/./ .Yell App 1 3.Yellow Applicant f ( ` ���/// (Please type or print and sign at bottom) ADDRESS ZONING(office use) \ o5 NC.A‘` n -1;tu \ ss 4 CoC / 3 LEGAL DESCRIPTION(office only 6 ` . LOT Li8'LDCK ' gDITION 114(11111/4 11X )1e°//7� )PID ‘7&-- / OWNE((Name) i ;a 1 \T)T 1 A- (Phone) LLD -- . 5 —03-9-; (Address) \. LO 1-i3q cv-Rviri," se & APPLICANT (Name) Chaf'ipion Ploibity (Phone) (Address) PC 0003013 (Address) 651-355-1340 (City) (Zip Code) (Contact Person) 3670 Dodd Road (Phone) Eagan, MN 55123 APPLICANT SIGNATURE DATE APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower • Roush-ins / Dishwasher 1 . Meab e1c 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 11 Estimated Cost $ 5 O Building Permit# The Minnesota Statutes§32613.148 "SURCHARGE"has been extended PLUMBING PERMIT FEE $ The minimum surcharge for a STATE SURCHARGE $ "fixed fee"permit is$5.00 TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved (id �'� SO LA Receipt Noil )q ol' Date By BaildinQ Official Date %� t 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 \\O