Loading...
HomeMy WebLinkAboutPlumbing Permit 12-0006 �k E ��� k � ■ krere‹ z < 0 T. E I , OO ❑o❑lic 2 G _ § § w t § 2 o g � § E 0 w - ° k § % § §�� w $ § k w m i w wz z . & 0 g 0 0 o z a2 § ■a � �1 00 z % � . 000000 — 2 2 § a a u 0 k § 0 2 « O. ■ z 2 � 2 z �� � \ ■ ■ © « / 2 �u.u.k§§ ■ ■ 0 $ S S 0 z < o a 000000 U O O _ ( G - P RIO R Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT 41 IA'NEsoo 1. Blue Fite 2. Gold City PERMIT NO 72 , 6 6, 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 1 /OA Fhiatsolyr( fl iptdo0 L.4%. 90 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER r ? (Name) G1 r ( (� (Phone) -1 5 p� /�f " �7 7 O Jz/ 3 (Address) 0 '• IL! / , I AA / / / , _, . A APPLICANT (Name) 31- 1815874 (Phone) (Address) Appliance Connections Inc f3lc3eDanita Circle (City) (Zip Code) (Contact Person) Shakopee MN 55379 ( )� �_ — / 'E �(_ t ` Phone APPLICANT SIGNATU DATE I' 4/0 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins Dishwasher 1 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 The Minnesota Statutes § 326B.148 $ Building Permit # "SURCHARGE" has been extended until June 30, 2013, PLUMBING PERMIT FEE $ The minimum surcharge for a 'STATE SURCHARGE $ .50 "fixed fee" permit is $5.00 TOTAL PERMIT FEE . $ O This Application Becomes Your Building Permit When Approved Paid Official Date A ` ,� Buildi Rec ' t No. � Date 2 ` B (r7 ng Z • 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372