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HomeMy WebLinkAboutPlumbing Permit 15. 1439 - 0 0- g. n OOOCOO -0 0 > E 2 0 § z8 � 28 z § k SG� 5 k r m m 0 m ■ � ' 0 zm 73„ co -� oa \ �� � ] -I m §§ � Q P z0 13 79- 2 eo Irot.- > U —I § z § hi S - 0 © , % n > 0 . m m 73 0 § § q 0 -1 m -n -0 cP 2 § o 000000 �] hi z - mm mmo0ts -a i E § o o .ir oc mxQ n ■ 2 2 f m 2 � 77 � § m z ` x 2 q , .0 - 0 q q o 0 � cc z C k z@ m -. r 17 P . m 0 14*. q k 0 \ ,� m 00000 § Q � 11nqt. § B PC C73 p3 7/ � 1/M 111 \ n � 0 0 — 4m XFf f?3-i m21 mmEr c � § 13 �. - .. . _ C - . : .d_ , - • - I RE° ofNI -I 4b\IIIIFcfi) A --:? •• • T CITY OF PRIOR LAKE PLUMBiNG P.E IIMI -..- . . - • Date Rec'd /3-- , .. i:..11::eld Poi,'ye 1 PERMIT NO. /5-:/ .._ Appbc (Please type or print and sign stbottom) . , ADDRESS" " 1 1 ZONING(office use) i. /5g&i -L:t/0,C1 View col A160 5537D‘ ...,..,..,t LE.4(1,DESCRIPIION(office use only) . LOT //BLOCK . /.ADDITI6N -/ 5(./.• if/1.). .ie‘.Z.t.). HD 25- Og5-- 0 --,I , • rim? InAr -- 4-141hDAc 6,2ten,Sie I 11) ' --- (Phone) .61 14 &&98-- (Address) ---(5(iilitC- . . APPLICANT (Name) Appliance Connections Inc(phone) . .. 1N350 Cheated Blvd. (Address) Shakopee,MN 537g4 < • (Address) a . r2-44.541803 (City) (Zip Code) (Contact Person) . rviit-e:.... 1s,.• •0 I (Phone) . 1 APPLICANF SIGNATURE 'It 40 i ' 4 IVO" ir" I . DATE iii—ii 3 APPLICANT PLEASE COMPLETE BELOW Quantity . Type of Fixture -Quantity " . Type of Fixture •• Bath Tub with or without shower Rough-ins Dishwasher • Water Heater • Floor DraindgC, , Water Softener Lavatory(Bathroom Sink) •. Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink. Sewage Ejector Shower Stall Backflow Assembly ,Sinks Bar Sink Water Closetffoilet) Backflow Assembly Test .Lawn Sprinkler Other ' I . FEE SCHEDULE Industrial,Commercial&Multi-family I%of job cost with a$4930 minimum Residential,Ntw One&Two-Family $149.50 • Residential,Additions&Aherations $49.50. t. -:-. The Minnesota Statutes§326B.148 $ Building Permit# . .SURCHARGE"has been extended 4 so The minimum surcharge for a • PLUMBING PERMIT FEE $STA SURCHARGE SURCHARGE $ •. I "fixed fee"permit4,45.00 . '... I i I,0 -•TOTAL PERMIT FEE $ 5--0, 50 , . This Application Becomes Your BUildiag Permit when Approved 'Paid (—1) Receipt No. 1 ,5.-171 1 • •, , . ' .., •. --: . paw I 1 --73°' I BY 3 ‘, ' - -'..-• 2411oir notice for all inspections(952)447-9850,fax(952)4474245 -- ''''_"-. -, 4646 Dakota Street SE.,Prior Lake,Minnesota 55372 • . . . _