HomeMy WebLinkAboutPlumbing 07-0429
g"r 0 000000 "ll 0 ~ -0
:z: ~ c z_
0 en."z."."." 0 C ~~
~ ::u () 5: =4zcn~OO z m ::u mo
::u ::u 3: !:!!>C3:!iS m ::u m ~."
m ;:I; z'>ZOz Z en
m en -"ll
::It! o en Z ~ ::I(i)~(i) ~ O::u
hl ,-t )>- z-
-~ -f m 0 - zO
~ Vi en o z 0
S 'TI ,-t Z o::u
)>- 0 ::I>
~ ()
0 -~ z 0"
." 0 )>- 0 mm
~ 0 )>- Z ;l[I
::u , :<
I 0
~ -l ." "tl "'D
. :z: 0 ::u :xl
~ m ::u 0 0 000000
z ::u 0 (') ~
~ m m m m 3:"tlen:e3:"tl
>< m rn
-l Z 0 c, m'~>m'
::It! en OC ,-tOC -:--
~ ~ Z ~ "tl :z:3: m:z:3: "tl 0 0 en
en m .,,!!!::U::U::u!!! m 0 0
~ ~ "tl ::J 0 zZ:Z::Z:-Z ::u Z ~ :z:
::! (1) ,-t
m ::t )>-(i)00 (i) ~ -l m
~ 0 () 0 ,.,,00 ::u =4 ;U 0
-l 0 Z -"" - C
~ 0 a- m ZCC z ,
Z :-1 m ~"tl"tl ~ m
~ N ." 0
.... 0
~ :z: ::u
m
~ 0 0 fa
C
::u 0 ~DDDDD
< I
en m
:i! z ;:0 (i)"''''0~
)0- z >;0;00 (' \) ~
~ 0 (i) enmm3:(i) -
~ ~ _"tl"tl"tl~ C0
~ z ifi>>>o -J)
0 >oOz:;;
3 !t' mm-l_
"'::u ' -1
I'b,-tz- C i
~en)>- z m
~, (i)
~
~ '1 lf~'1
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
ADDRESS l \l\L-\O
LD\nrodo <Dr 56
; ~~ ~::y I PERMIT NO. 0'7 (.) A_?O
3 Yellow Applicant , ..,....- ~ ~
I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID zs- 005: 0. ;0
~~~R .0t(t~ ~dl:~Ll C.
(Address) 4\.1 U 0 n D \ OYD' 0 c6t i1f)
(
{cto
(Phonef-1c)91441- 1~0 L I
.4'"
(Contact Person) \
(Phone) g e-,91I~;1) OC5SV
n ~ LL cJ0 ');1
(City) (Zip Code)
Phone) Q'7J). 9tI:li I Ory)!Q
t): I)f). D1
DATE
APPLICANT SIGNATURE
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 Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (I or 2 compartment sink Sewage Ejector
Shower Stall Backtlow Assembly
Sinks Backtlow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
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 #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$
$ .50
$ -=Qo O\rJ
" v
(Office Use Only)
Building Official
Date
o. 578(; I
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
~ LtO.00