HomeMy WebLinkAboutPlumbing 08-0162
:;- ~l 0 000000 "0 0 > -0
z_
1Il 0 J: ~ C ~~
"'C en'TIz'TI'TI'TI 0 c
(l) 3l:
g 0 Sl o 0 ::jZ(l)~OO Z m " mO
> 0 " " 3l: ~>C:3:~S m " m ~'TI
, :"'! " " Z'S:ZCZ z en
h'l , m ell m 9 en -"0
~ t o > Z ~ ::jC)~C) 0"
-i -i z-
h'l -I m 0 - zO
..... > - o z 0
K:l I o en en 0"
S CD -i 'TI .... Z
00 - > i5 ::j>
~ (II o 0
0 Z --4 Z 0"
'TI > 0 mm
~ 0 Z ~
" c
~ .... 'TI "0 "0
~ J: 0 :xl :xl
~ m :xl 0 0 000000
Z :xl 0 0
~ m m m m 3:"O(I)~3:"O
>< z m m m'~>m'
.... 0 0 oC: -iOC:
Z ~ (I) J:3: mJ:3: 0 en
a C5 "tl "0
en m 'TI~:xl:xl:xl~ m 0 0
~ ~ "0 ::J 0 -ZJ:J:-Z " z :r:
::! m (l) .... ~(i)OO (i) 3: .... m
~
~ 0 () i5 r'TIOO :xl :::::j ;n '" c
.... 0 Z -"" - c:
0 3- zc:c: z \' ,
~ al ~"O"O 9 m
Z :"'! m C
~ 'TI
N 0
~
~ J: :xl
m
~ 0 0
c 0
" < 000000 .t:~
en m
~ Z :xl (i)'TI'TIom
> z >$$O~ ' ~
Ro C (i) ~mm3:(i) ,,-,m
~ ~ _"O"O"O~ f'- ~
~ iij>>>c ~
z >ooz:;;
~ 0 _mm...._ 1>\'
!'" :xl'TI:xl r ~
....-- , i
enz z m
....~ (i)
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
~. ~~ ~~~ I PERMIT NO. oCt. Ol' - I
3 Yellow Applicant . U '- ~
Idc1
u'r[[Q 5W
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
~~S
lor La~
(Phone)
g0~-4LfD~3LfS5
(Address)
, .0557
APPLICANT
(N ame)
L;hamplon
651-365-1340
;;SljlO ~~f100
Eagan, N 55123-1339
(Phone)
(Address)
\PPLICANT SIGNATURE
(City)
(Zip Code)
(Contact Person)
(Phone)
ji, ,I"~
;,;.,
DATE
3~~~(]A
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39,50 minimum
Residential. New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
Estimated Cost $
Building Permit #
(Office Use Only)
I
This Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
16cr SJ
.50
50- U()
Date
Paid 50. 00
Date 4-- ..1.. ()o
Receipt No_.5:5Sc:e, /
By
Building Official
300 ( I
~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714