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HomeMy WebLinkAboutPlumbing Permit 15. 1210 I 0 n 000000 0 > En 2 nn ■ 0 ■ m2 -nmTI § & § �� o A 2 §`2 -IZc� co m m m mo § � � � � � � cn co -1 -0 tn i t ' � -i Z m �o -1 P z- v INK> m 2 q •.: cn q § $ . gre..aken 2 § ~ 0 { ox i m , 0 • 2 2 0 k q r o . 2 M o X 73 ■ 0 000000 WI Z • m m Em k B 0c Emo - 0 ' 7 § K f q § � � m § n ■ , Q q zzII - z ■ z 7 .• 9 0 z r -n § § 21 § p m § 0 i § . 'V-o o r St I 2 Q..... m c §0 ' k ■ ■ m rOOOOQ 1 / / § 22282 § • 2 "0Ti . § qt,,41 1/ 23-> � in1� m _� �_ F -1 @0 z m rr 0 04?RistQ/ Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT v �� 44NEse I. Blue File PERMIT NO. / 2. Gold City { 5-.. !Z/b 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) I `IO2a 'Fa.� s C+ c g LEGAL DESCRIPTION(office use oni ) I 17°12 LOT BLO ADDITION 1.914 PID (Name R rn Di S r l \ O(Av Y ! (Phone) q5;?- 4/5-5 Y L (Address) '9wni- APPLICANT (Name) Appliance Connections lac- (Phone) 12850 Chestnut Blvd. (Address) . ti; - :03 (City) (Zip Code) (Contact Person) / ,1I� ► / Si.' (Phone) APPLICANT SIGNATURE JdIU//411, �. DATE 9 f r APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher I 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 $ 461,5b Building Penn't# § "SURCHARGE,,has been extended PLUMBING PERMIT FEE $ U The minimum surcharge for a STATE SURCHARGE $ "fixed fee"permit is$5.00 TOTAL PERMIT FEE $ This Application Becomes Your Building Permit When Approved Paid h 50 Receipt No. 3© Date , l By s 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