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HomeMy WebLinkAboutPlumbing Permit 15. 0727 E 00 n 000000 13 0 > zo n n 0 e11s "TI 'II 0 § o 79 4 § r 2 2 2 3 m §cEE _§ m m 02 \ § Z tn k -4 PN Ca 0� § § § Cn 0 2Z § d 7 2n o � \ o a > o m ■ r § 7 oQ Z k O O 000000 Z 2 m x m m 41 m � � \ 3 OS .4XI 0S n ■ . E m › 090 0 3 k | tviq U 0 " §o o ,_ . z � m m r *a � � z m /� k \ 0 ti m OooOQ PI zo � � n § ® Omm2§ - E-u - -0 ° z m5 5 5o § t � ! r � t § � r o `-� t Date Rec'd E°0113111) CITY OF PRIOR LAKE PLUMBING PERMIT q <r 'fNNESD� I.Blue File 2.Gold CityPERMIT NO tt�++JJJ • /� /�� 3.Yellow Applicant f / (Please type or print and sign at bottom) ADDRESS ZONING(office use) 3 'r Stevt S dr Si.i LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) APPLICANT (Name) (Oe_n/atA... Q(u Nt 61,..v\ (Phone) / L - 2.70 tS X 7 (Address) Pb 6a/... ( 2 -� L. .5-s-3-7 s (Address) (City) (Zip Code) (Contact Person) - (Phone) APPLICANT SIGNATURE "Z - DATE 4 /2 t (/ /s APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher A 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 The Minnesota Statutes§326B.148 Building Permit# "SURCHARGE"has been extended LUMBING PERMIT FEE $ 1t4f,rt) The minimum surcharge for a CATE SURCHARGE $ "fixed fee"permit is$5.00 OTAL PERMIT FEE $ This Application Becomes Your Building Permit When Approved Paid —�/�jj ipt No. qr./ Building Official Date Dat • 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372