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HomeMy WebLinkAboutPlumbing Permit 15. 1305 0 i n n * OOOOCO o > n § § § 2 0 ■ � � a � � § § § KJ % � m 2lcc/ m mo © m � �� E§d z 2� Z 17 hi ■ > z � z 9 ■ 0 t6 I 0) 0 2 �2 � zJ \ ad - z -1 4 0 Kx § r § 7 / i . m m k o xi 2 f % z ■ o o / 74 m m m �■ OOOOCOtj / 2 2 0 § �► .1 ■> ■ , � » m k C ƒ n xm m. s , n ■ A m _ ■■ , § m 0 0 A / z I§oo § _3 m % 2 I-- -n C m zc / k -Ti z x x o k 2 z § )OCOOQ 1 § o �in§ > I �mm2o $ m % � �i\kE tmm / q ■_ p 2K z ■ e ( ,- (.r: PRip CITY ® ' �' Date Rec'd I,A3 �'LUMB NG P IT /0., 2A,*"; illiC.) 1'27 4II'NESO' ' I. Blue File I PERMIT _ O. / 2. Gold City 1� �;/305"" (Please type or print and sign at bottom) 3.Yellow Applicant ADDRESS ZONING(office use) 12O Shore, Ln /0 Put LEGAL DESCRIPTION(office use only) LOT'-BLOCKY. ADDITION /E/}) 4,,,,k, DID 25- 2 /S- O 7- OWNER (Name) Pain A 13)nci i n (Phone) ?5a -- as 1 - 7a91-1 (Address) 11- x,90 Shore Ln i\/ ' APPLICANT (Name) channel en p1Urh}))X1(9 (Phone) G,51- 3&S-)3`-/D (Address) 36'7O Dodd Rd 1✓a g a r 531-a,3 (Address) (City) (Zip Code) (Contact Person) ebeC f 1g.rG51-365-1390 (Phone) APPLICANT SIGNATURE DATE Jo I 1 C 115 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rou h-ins Dishwasher IcW ,ter 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 ost $ Building Permit# The Minnesota Statutes ti 326B.148 "SURCHARGE"has been changed for one PLUMBING PERMIT FEE $ year effective 5d fLio July].2010,until June 33,2011. STATE SURCHARGE $ .50 The minimum surcharge for a"fixed fee"permit TOTAL PERMIT FEE $ SQ e1O is 35,beginning July 1,2010 This Application Becomes Your Building Permit When Approved Paid Receipt No -7,70 co Building.Official DaDate By Datto. 2-(, ..—�S • 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372