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HomeMy WebLinkAboutBuilding Permit 14.0842 0 J I.. Ili Z _ 1y o: u. Ili W L �" WV Z *g55z > iJ x(09aWWy Z < y-4 7 iLioL. u. o W Z 0 ---__ - Op --L I 000001r V O W 0 x p _. d 4 J `, m C O c.3 W O xZ I Z ° F g 114 p C. d M 02 Yo $ 0Q 1, 0 d lu j W Z K 2 _ xxZz W e y O 11. N 0 a smilax �� N 2 a V ~ O V W W Zril- x -:sl a � 3ya1E ��� v v CC z —� 000000 MI IU a d 0 W p J Ix Z Y _9 . 0 < c:3 111 lc v " 0 1i IL 0 .:C4 Z co 0ii .....; co 0 0 A 8 p lig I-7 aOZ F- a Z rg y V w rt o a w N Z HpZZ � < W O O O ve V 0 Oa ILI re W Z OOE= z1- a p O u. � u. _ �y p 3 t� 0 §. 0y c 2 < 0 a 000000 0 ' ❑ 0 C.. 4 PR. 0 Date Rec'd 4 CITY OF PRIOR LAKE PLUMBING PERMIT .t."44411 7 /1( i 4eliviase I2.Glueold Cityit PERMIT NO. ` F4/2....2.Gold r 3.Yellow Applicant i (Please type or print and sign at bottom) ADDRESS ZONING(office use) 3( o WH Icts ('))vio 4'b LEGAL DESCRIPTION(office use only) //'' '' aLOT 3BLOCK / ADDITION ✓UJ QR}A ith PID RC-3e23., 0-3r 0 OWNER „,,,. . (Name) t (Phone) .(/qI �/g (Address) 31 ; (p Wt I C J F--) ole e APPLICANT (Name) Champion Plumbing (Phone) (Address) 365 PC 000308 (Address) 651' -1'40 (City) (Zip Code) 3670 Dodd Road (Contact Person) tiont4 ph5123 (Phone) APPLICANT SIGNATURE DATE 1 I/V APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower -. s Dishwasher r 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 of $ ' // Building Residential,Additions&Alterations $49.50 54jl Permit# The Minnesota Statutes§326B.148 f "SURCHARGE”has been extended PLUMBING PERMIT FEE $ `-11% � The minimum surcharge for a STATE SURCHARGE $ 5 oww -- "fixed fee"permit is $5.00 TOTAL PERMIT FEE $ /-il'e © This Application Becomes Your Building Permit When Approved e'• I c9 Receipt No. `+ i 1'Date By Buildinc Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 A. 1, 1111% 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372