HomeMy WebLinkAboutPlumbing Permit 15. 1012 JQ
lu Z T I--
zww < 0 w
2555W
c -� wVLL. a0 Z 6
C I ❑ ❑ ❑❑ ❑;� 0 u
D
.11 W x
N
0 'J J 5---- re
w z o
LI a » a z c 0 L
0 44 a' H x Opal J 0 0 0 <
O < 4 0
_ z z _ xxii 0 c ..-
0
N v a 00xw � m = a 8 Z
W Q W O w Z F- p
aa3Na2 w W w W
re z
'l 000000 c00 0re
t cc O w `r
a a a
0
w `� 0 _ 011 0 III
Y V 0 �J Q O 40
o1 _
pZ O p W FN- H � W
zr. a < f- ► 04
aOu_0 N Z ZOZ � JZ LJJ YILI W J.71 Q
L
CD
Ow re w Z 00 " 4: E 0 0 0 0 U
aa a E 0 aaa= CTw 3 v v b
z < 0 a 000000 C) 0 0 c
O� P IIO� �/
,, ; CITY OF PRIOR LAKE PLUMBING PERMIT Date Recd
�I VNESO
._)
I. Blue File I PERMIT NO./5 l
3. Geld App /L—}
(Please type or print and sign at bottom) 3. Yellow Applicant
ADDRESS
4 142 C O ere�rno v\ La,
ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION
PID
OWNER ('� I
(Name) C-'V111- \ U u-1 1f Gla 3 �
` (Phone) � ���y-I
(Address) 1 Ci 3 COo.c11 1,10„,„ Lv\ P5\" L„Vt. . !1V g..63?
APPLIC
(Name) L91c\'Mp\p4'\ U v yyi \n
(Phone) S ) 3�p� '
(Address) 13(1570 Do e V c-one,NIN ‘S J;3
(Address) (City)
---1.;
'� (Zip Code)
(Contact Person) ►( 0 6-0 0
(Phone)
APPLICANT SIGNATURE ,j--80.-04771 '/ DATE Q U I 1 1/Ad -
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixtureuanti
Q ty 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)
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 ti 326B.148 ost $ Building Permit#
"SURCHARGE"has been changed for one $ LVA SO
year effective -413
PLUMBING PERMIT FEE '1
July 1,2010.until June 30,2011. STATE SURCHARGE $ I 1
The minimum surcharge for a"fixed fee"permit TOTAL PERMIT FEE $ . •5 O
is S5,beginning July 1,2010
This Application Becomes Your Building Permit When Approved Paid
,c'I-a eipt No. 2:1 O�j
1.
Date /
Building Official Date V 3 t, t S
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
4137