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HomeMy WebLinkAboutPlumbing Permit 15. 0776 E 0 O § n I 0 0 \ 0 O 0000 0 o > E0 b r R 3 2Bkoo 2 A 2 2-r k r _i > m Z PE0z z 2 29 ? -4 > ■ Z C _—I®q ® P oxl Ce 0 0 \ z k % -r, a d z R§ XI § qi m m% mz o o ON41 x / § 000000 7 ~ Col 0 0 2 m mrismr m 2 0 en m �, \El■ xi_\k m 0 0 g 2 0 z0 >K9§ 0 z - m / 2 $ ■ t rII §o xl LI 7 0 m zxm 1 C / k 0 r-§ § § m r m c0 ? 0gi R. /JOooOce t > r 'mm 0 4 ri;;5§ n ts » 0 ©Em _ m?; 21 -rix -4r —I Z- - s —1 > vRlp Date Rec'd l CITY OF PRIOR LAKE PLUMBING PERMIT .y /c � S°�� 1.Blue File PERMIT NO. Yell App /S • �� 3,Yellow Applicant EEE��� (Please type or print and sign at bottom) ADDRESS ZONING(office use) lC CyWO Crin►Ethel et S5 LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER �rr-- (Name) G�I/^i S Pe 7t r.5 cs n (Phone) (Address) APPLICANT ---� c (Name) v S PA v.% l'/fig (Phone) 9�a-(10 (Address) 5( �<vl nP5al✓ S)(‘ .S• SAG(Doper SS-379 (Address) (City) (Zip Code) (Contact Person) Mtk Sd h (Phone) 9 S1a 'e/°6— )-4'`f 3 APPLICANT SIGNATURE 1 -— DATE 7 3'-f S 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) VLaundry 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.14-6 $ Building Permit# "SURCHARGE"has been extended The minimum surcharge for a PLUMBING PERMIT FEE $ "fixed fee"permit is$$,00 STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ This Application Becomes Your Building Permit When Approved Paid 53 Rece. No. z. / C� Date 7,O ` i By Building Official Date O 24 hour notice for all inspection (952 447-9850,fax 52)447-4245 4646 Dakota Street S.E., ' ti I't:101'..'I , ' I a 55372