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HomeMy WebLinkAboutPlumbing Permit 15. 0703 5 0c ' n 000000 o » 3n n 0 \ 0 0 0 . g q � Bxoo z xi rq % r R xi x x s mr- cEg - m 0) °@ a„.* t \ \ > Z -0 =B § B z73 ~ * > ® —I m 0 © �0 q B 2 9 . 9 o n z -1 z 0 x \ o 0 - o m ■ r 0 7 / rn 0 z 7 til I % z XO O 000000 / \ § r7 c l& ■ r ■$rnr ■ OE .10S | 2 � f m - q § ■ § x § rn 0 ■ 4 E m q zzzx � z ■ z i q -Ir •C) z i xx - c o ' to ' r>zcc zr z # m -0 -a P§ § / A X m 0 m '4OOOOO 0 E 73o11 iin @ o R. > o (3 » ■■ 02 ' Fs o ■ mm ■ 0 > zcrr vq 0 "„00E § m � 1.1a r k § 0 v.,a/ch ~� { CITY OF PRIOR LAKE PLUMBING PERMIT Date Recd � r i-,OA -,,; i U �� T :Z / / l , � S 414NEso1r ,.s, F;,e PERMIT NO. z.Qold c,Y 'TO. (Please type or print and sign at bottom) 3. Yellow Applicant 1�� ADDRESS 554(a O e c �r 1 S t ZONING(office ) LEGAL DESCRIPTION(office use only) LOT / LOCK / ADDITION �5 PID /2 7.. a/0- 0 ...„-- (Name) T J d KQ.nYYpC. (Phone) (o12 !LOg"b9- (Address) APPLICANT (Name) LAN P AirrIbinl -b Apprld yhi- �1'1G (y���j .J (Phone) qcJZ"y�� '. $'�c { (Address) g 1.17 5 S"t- toe . /)-0)--- 14,162_ IAN i J .�3 R-Z k, 1-(Ad ess) (City) (Contact Person) C t"d (Zip Code) (Phone) APPLICANT SIGNATURE ____441.4 DATE (O I 13 I I --- APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Bath Tub with or without shower Type of Fixture Dishwasher Rough-ins Floor Drain Water Heater Flooravatf Water Softener ry(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(I or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet(Toilet) Other FEE Industrial,Commercial&Multi-family I%of job cost with $49.5minimum ULE Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $49,50 The Minnesota Statutes§32613.145 ..est $ Building Permit# "SURCHARGE"has been changed for one year effective PLUMBING PERMIT FEE $ • < c0 July 1,2010,until June 30,2011. STATE SURCHARGE The minimum surcharge for a"fixed fee"permit $ DA is ,beginning July.1,2010 TOTAL PERMIT FEE $ ,sa This Application Becomes Your Building Permit When Approved 'f•. P Receipt Na ` . Saildine Official Dat Date / r r (, Ellirde/M11 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 II 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372