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HomeMy WebLinkAboutPlumbing Permit 13. 0996 __ n 00000E o > - n (b 0 o 0 0 g z o V) 0 Z m k � 0 o 2 2 0 m >c C0 m m M O ii k r m m m z b. E ° z § ® 3 2 n n Z $ ® ®b z- gi tO f \ - Z z 0 2 7 0 o , $ • \ \ X § 7 / ) m \ m 2OO 000000 e z mqq ■a- ■11 CR *■I glo x ! 1 C C Z P / ��� k § X1 X73 k m 71 o } k\ - § o rmOO %§ Fi 0 \ 0 \ Z zc§ z § § } � � �� P o I o I M c 0 0 n x m m �OO000 ■ t 2 q Q23n 1 ® ; f z »? ■■o › \ < //° § / § m xi -n 2 • J k z m Z wr 0 0 4 4 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT r v a rsoq � 3. Blue it PERMIT NO . / f 2. Yep Z_ 99i 3. Yellow City Applicant � (Please type or print and sign at bottom) ADDRESS ZONING (office use) n\ lAr,ect t .meadow Ln LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER 6 , 4`10 (Name) /cam � � �� V ��1. ' (phone; ,5a (Address) 4)( 1 ( Y r l( 4- 7 ! APPLICAN (Name) ( ? UX1OIV 5 (Phone) cC. (Address) r_■ 0 ikti C , A V _ , (Address) (City) (Zip Code) (Contact Person) "VV\ (Phone) -3k:' p '' NC APPLICANT SIGNATURE DATE 7-7- APPLICANT PLEASE 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 Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler _ Water Closet (Toilet) Other FEE SCHEDULE Industrial, Commercial & Multi - family I% 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 PLUMBING PERMIT FEE $ 4q. G,n The minimum surcharge for a © �lJ STATE SURCHARGE $ 0039-- - "fixed fee" permit is $5.00 TOTAL PERMIT FEE $ ( -3 - q"- 1/4 0 C This Application Becomes Your Building Permit When Approved Paidj j T/1 Receipt No. pd // Buildine Official Date Date 77 /fh `/ % Byi4 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 1_10/3