HomeMy WebLinkAboutPlumbing 07-0612
:;- 0 (") D~DDDD 'll 0 > -(')
l/l ::t ~ C z_
al 0 0 0,,"Z"""""" 0 c ~~
8 Sl 0 3!: =4Z0~00 Z m ::u mo
0 ::u 3: ~>c!:iS m ::0 m 0,,"
~ :-1 ;:0 z'S:-c- z 0 ::!'ll
m m 0
:., 0 Z ~ ::!~~~ 9 o::u
z-
ttJ -t m 0 - zO
lC:l en o z 0
S -t Z 0::0
~ 0 ::!s:
Z 0"
~ mm
~
~
~
~ 000000 [V
;:0
"!l m :I:"0~:I:"
~ Z m'~>m'
0 OC -tOC ~
~ ~ ~ " :I::I: m:I::I: 'll 0 0
m ,,"!!!::O::O;:o!!! m 0 0
Q ~ :l 0 ZZ:I::I:-Z ::u Z :I:
::! III -t >G')OO G') !: -t m
~ 0 ,,,"00 ;:0 =t ~ c
~ ()
0 Z -;::l\;::l\ - Z C
~ a tll Zcc ,
~"" 9 m
:-1 m c
~ ""
0
~ ;:0
m
~ 0
0
< 000000
m t~
~ ;:0 :!!:!!8~
Z C') iil
~ G') 0;:0;:0:1:
mm G')
~ 'll'll'll~
zs:s:s:
~ moo-g
~ mm~:!! -4
~~;>1 E i
-t~ ~ m
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
at bottom)
I Blue File I PERMIT NO I
2. Gold City . 07, 0' - '*7
3 Yellow Applicant , \.(' e-,....
ADDRESS
ZONING (office use)
IAl-kl,l- SIYf,f,/ SF
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
J
t6iff /JljC(
I
JJl,~1f Il),
(Phone) -44 1/'17- 77%7
(Address)
APPLICANT dli flit.~' ~/Z) iZ?-'1tJj~
(Name) I?r. ~ HI 'K~ W7 ~ (Phone)
(Address) 2.cr()~ {YtU/;:;d live f ~~y) ~.rft:)1
(Address) (Zip Code)
(Contact Person) h /J (Phone)
APPLICANT SIGNATURE J C) -/fl -- DATE
t ~PPLICANT PLEASE COMPLETE BELOW
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
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 $ t(()O 00
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
11. '5"?J
.50
LIt) .00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Paid 40 (I (;
Date,? ? . 7
. /..), (;
ReceiptNo. 51- zoS
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714