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HomeMy WebLinkAboutPlumbing Permit 16. 0076 o xi 73 xi o � 0 2 � 22� vo § QV C) �rKk $•otrt X rn ZErca2m om0mm 22 Z § cn �% t k , BSk Ce _o w • © Z 0 0 7 0 © A n o § r - 7 W m / 4- 4. z xo o li 000000 61 \_ 2a0 mri > mr h2 ■ » m $ .1 z ? , ' zs mi § 2 $ ; m 711 ■ ■ ,3 � m 0 . . 0 iii M - . z § z ■ - z Z Z Q x tn 2 o 0 �2 §k xl Z A k 0 z ® m § � Z m ■ o o m © 0 m . _ ■ m y 2 OCOCOr _____. R. » z ii � nm , N > 7 0 CAMME® h "I 2 c 41 z ri ; ; ; t 40 = » mm4 ,t c 1- -I - E � z ■ -Ir o Oie 4R/04 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT Z 7 . /6 I. sole File PERMIT NO.� , �/„ 2.Gold City �(((// 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 413 Co f o '-ads - S2. LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNE (Name) ) c>�. C s- A (Phone) (Address) 413 LI Co iv e ad u APPLICANT (Name) se,* (Phone) (Address) (Address) (City) (Zip Code) (Contact Person) (Phone) APPLICANT SIGNATURE DATE APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher x 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 Estimated Cost $ Building Permit# The,ivlif.nesota Statutes§32613.148 PLUMBING PERMIT FEE $ '�`l "SURCHARGE:"RCHARGE:"has been extended STATE SURCHARGE $ `( The tofu r� m sur ly< ec for a TOTAL PERMIT FEE $ "fixed fee" permit is (Office Use Only) ✓ ' ' This Application Becomes Your Building Permit When Approved 5-3 Receipt No. 4.100, Date4 ,tkii • //, By 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