HomeMy WebLinkAboutPlumbing Permit 09-0220
:;- ~f 0 000000 " 0 > -0
VI 0 :I: ~ C z_
"0 en"TIz"TI"T1"T1 0 C ~~
~ (\) :s:: =izen~OO Z :;l:J
0 Sl m mO
> 0 ::c :;l:J ::c 3: ~>c!:~S m :;l:J m 0"T1
r :1 ::c ::c ;:I; zr~zoz Z CIl ::!"
r rn rn en m 9 en
>:i :t 00> , Z ~ ;:jC)~C) 0:;l:J
-l -l -l z-
t'tl -i rn 0 - ZO
lC::l ~ > - en o z 0
o en -l Z 0;;0
~ CD "TI
co > (5 :::is:
~ 0'1 0 ,
0 -l Z 0;:1;
"TI 0 t mm
~ 0 ~ C
:;l:J r :< -
~ -I r ~ 0\
"TI "
~ :I: 0 ;lJ
~ m ;lJ 0 000000
Z ;lJ 0 ~
~ m rn rn ~"en~~"
x z m mr~>rnr
~ -l en 0 OC -lOC f'l
:< ~ z ~ " :I:~ m:I:3: " 0 CIl
~ en rn "T1~::C::C::C~ m 0 \j) 0
~ " :J 0 ZZ:I::I:-Z :;l:J Z :I:
::! m (\) -l >C)oo C) i: -I m
0 :::t (5 r"T100 ::c ::j ~ C
~ 0
-l 0 Z ~ -;:1;;:1; - Z c:
0 ;a. ~ zcc fJ~
~ m ~"" 9
z :1 rn
~ N "TI ~
~ 0
~ :I: ;lJ J
0 rn
~ C 0 , ~~
:;l:J 0 ~
<
en rn 000000
~ z ;lJ C)"TI"TIO~ b~
> Z >:ii:ii0
Ro c C) ~rnrn~C)
~ ~ -"""~
~ z fij~~~o
0 >ooz:;; f" ~
~ _mm-l-
rn ::C"T1::C r -l
-l-- r i:
enz z rJ m
-l~ C)
~
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
]. Blue File I PERMIT NO I
2. Gold Cit~ '01:7, 0" '? 0
3. Yellow Applicant , 7- ~ ,
ADDRESS ZONING (office use)
iS528
o .,. I l'C" L... '
i<:. k ct L,l Ie .
SE
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
&b j;
~ft+hy
BeVIS
(Phone) QS2- I..j "(T- k-7Cl1
(Address)
c'"'""l...--
,)t.
APPLICANTr, .
(Name) ~-k (n t.i-ll Lt S 'PI d__ h,dJ (It (,) i Jft ( .
(Address) \ \2 If\S+ S-lJ1S-tr€ct .\lu~1c Ie /
(Address)
(Phone) q c;2 -3l.(i 1- C 12 ~
Ch(\.~;k- {\. S 53 I 8
(City) (Zip Code)
l-kl d(
APPLICANT SIGNATURE ,_/t-t€utt - 8ti~ flZi-CI l{ f)
(Contact Person)
(Phone)
DATE
1:)- (y- c/l .
Quanti
APPLICANT PLEASE COMPLETE BELOW
T e of Fixture Quanti
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavato (Bathroom Sink)
Laund Tra 1 or 2 com artment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
e of Fixture
Machine)
Test
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
Estimated Cost $ Building Permit #
PLUMBING PERMIT FEE $ ,~ Cj . 'SO
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ SL\-~
Buildine: Official
Date
Paid !JJ i lfD
Date 5. ~l;,{)
eiptNo. S77~
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372