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HomeMy WebLinkAboutPlumbing Permit 14. 0386 J W : MU/ Wm z I- P . LL! 7 2 U. U lr !- ZVVaQ555W o zIN z a W �• O � � a 2 Z I- U u tL 0' ig) W O ❑❑ ❑ ❑ ❑ > W U 1ce Z LL N 0 W u z W a aaz m c 0 W z F O U 4 J F- 00 �- J 0 d W j li z z _ = S z ? W A N CZ U 0 W m � � � ma H Z qC H U 4. D2X INZ U DU W W Z x u. J W J W W a23v� a2 v v rt z 000000 Ix W 'c a a LL Fz- �' �� t4 < <CJ 0 W LU z U O Y a U O 1 oU. 0 2 z g 0 d0 Z F- N aw U N • oC W0 p U < z N W Y W W 4 Q Wm. N ILI W FZln< W O O O U P,,- Z U oU Q 2 0 $LL�ZLLy O Ti U U 1. �/l \1 c U ? a O a 000000 C.) ❑ ❑ ?Rlp"30Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT ted p"` PERMIT NO. ,41_ GolCity 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) / '/// ,2 ,'Ku/e. Zo/I-c 0,0 LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) #1 (Phone) / �� �' (Address) /w5/5/ f ' ' YXI APPLICANT PC 000308 (Name) 651-365440 (Phone) (Address) 3670 Dodd Road (Addf, MN 55123 (City) (Zip Code) (Contact Person) hone) z APPLICANT SIGNATURE DATE J//,.�y 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 ,J© t $G� Building Permit# The Minnesota Statutes§326B.148 "SURCHARGE"has been extended PLUMBING PERMIT FEE $ The minimum surcharge for a STATE SURCHARGE $ 50 "fixed fee"permit is$5.00 TOTAL PERMIT FEE $ ,SD This Application Becomes Your Building Permit When Approved Paid 5—// -6 Receipt No. 7/Lty gBailDate J-724)/* By 1,s," dia¢Official Date (4 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372