Loading...
HomeMy WebLinkAboutPlumbing Permit 15. 1129 l 1 \ 2 _l\ 4 id \ § �� ! k ° ��� O �aaaQ E K ° ce G_k1 w _ buu. u. o . > 2 0 r • & OOCOO 2 = d 0 N \ � t § 2 z © k Q 0 2 2 }}7 § 2 § K 1- m 0 000< 0 2 f § E z & 2 —� x� I \ k 0 w §\§� �§ UJ al 2 � 12 «% Eth 0 7 $ $ 7 ,t O0000O � @ C) 4( C) U.rd \ § i K ■ � ..§ z $ 2 ■ § k ob , § L iri < 0 0 § % —z o r o 5 & Z & & q .3 2 �� ® §2�m -su1 2 0 0 S g °- 0 t 0 uL U.U� 0 kk 2 % I OD0000 U C-- �4PRI0� Date Recd . CITY OF PRIOR LAKE PLUMBING PERMIT G' ZZ_f. ls v W I.Blue File 2.Gold City PERMIT NO./37 /j /Z 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 611 yew Cr- LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNERe ,�f q 742-'/070 (Name) �'u44"4" 47 'n� (Phone) (Address) APPLIC(Name)ANT J-.�01 ,:O vr (Phone) Z'AO 4�c'V5 (Address) ,C2'"/2- CAt i fr illk /1 1/1e/e4—_ - /Z, (Address) (City) (Zip Code) (Contact Person) 1®2d- '-C- (Phone) APPLICANT SIGNATURE elDATE 9-72- 'C 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 l 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 /6 i tie Minnesota statutes s sznn.i'+u Estimated Cost $ /7/7- ..0 Building Permit# „SURCHARGE"has been extended PLUMBING PERMIT FEE $ The minimum surcharge for a STATE SURCHARGE $ / t eV "fixe d fee"permit is$5.00 TOTAL PERMIT FEE $ Si'..Sh (Office Use Only) ..,. ,,. r. _ , _ o-,.,,„ 4 A n This Application Becomes Your Building Permit When Approved Paid sU 327 Receipt No. 04/4„... Building Official Date Date f 7i� IS By iffy 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372