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HomeMy WebLinkAboutPlumbing Permit 15. 1459 J 001 n 000000 x 0 0 2n nn 0 ■ ' s-nit-n o & § 513 -4 0 0 0 . s �� 0 m m �o O 0 m 2 � k� kz ca Co �\ r n n ■ Z ®� ® ' z - % t * > - -I m 0 o z 0 10 w ■ ■ . © z o 7, q C o k 0 0 ti 0 r § ✓ 0 S) m Z k0 0 voOc = O 41 m ° m• m m c r r o C c 0 / ? -0 k � � } � � 2 \ k 0 rm00 73 g p p1 0 q / �� > cc z r z # m r -0 13 P -, 0 / A 0 / c \ gi 0OOOOO _ 1_ o Li E z r p22 § § m ■ mm ■ o � - % v 0 E -u -u � m / dzs \ z . in Pi § m q - F k + -Ii 0 • O1 YRtp$ - . ' • . Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT 2 can cry PERMIT NO. 6. /`i s--q 3.Yellow Applicant (Please type or print and sign at-bottom) ADDRESS' ZONING(office ) kt 1,:.. (2g 0 '-e. J S� RiSii LEt DESCRIPTION(office use only) LOT 3 BLOCK • ADDITI'eaON F / e,ei G� • PID 2J- /3 o?-6'0 i—0 _ �`� /'bnd O Q4.=— s -- (phone)9d— Phone)GI -� -WO 0W3V (Address) .SA ,rnz...-- APPLICANT (Name) Applience COnOt1S 1t1C,(Phone) 12850 Chestnut Blvd. , . (Address) Shakopee, MN 5379 . 1 (Address)c) 99?-4145.48(13 (City) (Zip Code) (Cony Pec m Y rtcorra (Phone) APPLICANT SIGNATURE tl ,//�� . .� / DATE 1 a' . -� r • APPLICANT P • E COMPLETE BELOW Quantity • Type of Fixture Quantity - 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 Y_ Sinks _ Bacldlow Assembly Test Bar Sink °•Lawn Sprinkler Water Closet(Toilet) _ Other ' I . FEE SCHEDULE - Indusrtrial,Commercial&Multi-family 1%of job cosi with a$49.50 minimum Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $49.50. i. ,,•.s The Minnesota Statutes§3268.148 $ Building Permit# ;; • •"•SURCHARGE"has been extended #1--r° - % The minimum surcharge for a -. PLUMBING PERMIT FEE $ "fixed fee"permit-s rrr.0$' • STATE SURCHARGE $ L OD''P i D4 TOTAL PERMIT FEE $ 50, .50 This Application Becomes Your Baling Permit When Approved 'Paid 0 D <0 Receipt No,/,i',5(-14 • Date .Ba11dine Official:••:... . Date 7/2 • l I� _: