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HomeMy WebLinkAboutPlumbing Permit 15. 0907 w \z ■ mow ■ 2 / K � vv � t _ iiiiiii 022�� � 0 0 (� OOOOO 8 Pe 0 $ 0 III 2 « _ m t 0 § p K i3 02 E o8cc \ .6 \ ° L % z 2 EE222 � & § I g to § IE § x ooz_ 44 DUB = ° w w � ii -JUa1 � � a ■ ■ coa ■ U 000000 - o ■ w \SI cc a. cc � � � :3-- w0 z a 0 % ILI § g Y 0 2 b 2 & 5 I= z 17" iii Eg . � uul z © 88 L 2 w a§ ■ z 0 :1. 01=E z © le le w t < E b8 izi g W W kkg07Z � & S S & �& § § $ u. u. u.■ ■ a f O O O U ■ « 0 a 000000 0 . , Date Rec'd PRAI0 I, - CITY OF PRIOR LAKE PLUMBING PERMIT H Cy INNESOro"' 1. Blue File PERIVIIT NO. .Gold City [5 90 3.Yellow Applicant !!! (Please type or print and sign at bottom) ZONING(office use) ADDRESS Uu-Z4). Tonc10c-00 At-v._ ,z5"-. LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION - PID OWNER 1 ` CT . ( ,t)\ \ ` '�C (Phone) (Name) '' 11 1 �]"1 ' t (Address)q -2,`Q Ths,-,a\,)\eLs2_ —rec— APPLICANTchampion plumbing (Phone) (Name) ,,C 0003°8 (Address) r�r^ _365 (Address) 3670 DoddRoad (City) (Zip Code) (Contact Person) .. ,n, MN 55123 (Phone) APPLICANT SIGNATURE — DATE 1 K OF APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower RO1]--is Dishwasher i, 'Tater Heater Floor Drain a er o ener 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 ost $ q)C--) Building Permit# The Minnesota Statutes§326B.148 "SURCHARGE"has been changed for one PLUMBING PERMIT FEE $ year effective STATE SURCHARGE $ 50, Ju 1,2010.until June R.2011. S� The minimum surcharge for a"fixed fee" permit TOTAL PERMIT FEE $ is 15,beginning July 1,2010 This Application Becomes Your Building Permit When Approved Paid ,,r,-v Receipt No. G, 2.... DateBY , Building Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372