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HomeMy WebLinkAboutPlumbing Permit 15. 1246 C9 E 0 0 n 000000 v 0 > E n 0 a 0 0 0 . 0 § JKI :§ i k CO/ § q s r � ■ z � § qI, 111 r m m ■ m B � E2z p ® 0x 10 t � § § -1 m 0 �� � Z� § 4.0 7 0 > z = 0 z - m m § 2 r Z 3 � r 0 3 I-I -n 71 'a k 0 0 000000 41 . § m m mr ® ■ ■ r _ 2 § o r © C .40C § f 71 § ■ § M § m 0 0 ! 2 m q > 020 0 XI - X m U z ` t- -n 73 p o § 0 71 m . r � � 5),.. :1 § o ■ o cA I m c m . 00000 9 q k" xi > 0 � ,1 k rts 2 ® r -p .o ' ® ' � m \ zo §momo \ § § m q � ■ r # / -1r G Cri--VRIp Date Rec'd CITYOFPRIOR LAS PLUMBING PERMIT Q ery VIVI 411'NEsoc/.- 1. Blue File PERMIT 2.GoldlApp PERMIT 1 NO. l� J., 3. Yellow Applicant / t/G (Please type or print and sign at bottom) ADDRESS � ' C,rossaindrrA. � ZONIlVG(otliceuse) CJ S� e LEGAL DESCRIPTION(office use only) • LOT 114BLOCK ( ADDITION -1�`o 1/ �U 4t �_c (P (� PID z3- / ti - n) -O OWNER3 -? (Name) ��h� n S (Phone) '7 S0)'S� ([�.c(�J1/ (Address) ,itilAf Champion Plumbing APPLICANT f C 000308 (Name) (Phone) bbl-365-1340 (Address) 3670 Dodd Road (Addreeiga fl, MN 56123 (City) (Zip Code) (Contact Person) (Phone) APPLICANT SIGNATURE ‘....j.cifticlaelek. DATE /D $- /S APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower R Dishwasher Water Heater Floor Drain cater 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 'ost $ 3720-Ov Building Permit# The Minnesota Statutes§3268.148 "SURCHARGE"has been changed for one PLUMBING PERMIT FEE $ ye�0 0. r un ii June ' STATE SURCHARGE $ .50 July ,, ..,10.untilJune30,..01i. /� The minimum surcharge for a"fixed fee"permit TOTAL PERMIT FEE $ Q.s o is 35,beginning July 1,2010 This Application Becomes Your Building Permit When Approved Paid 5-0 -® Receipt No'5 l 10 Date By Building Official Date (i7 ,q . (C (C 5 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372