HomeMy WebLinkAboutBuilding Permit 09-0609
5" 0 0 r 0 000000 "'D ~ > -0
en 0 :I: 0 z_
~ 0 0 (I)"'z"''''''' 0 0 ~~
~ 0 a- 0 0 s: =iZ(l)~OO z m ::u mO
> ::D ::D ::D 3: ~>ca::iS m ::D m 0."
r- ~ ::D ::D " ~r-S~~~ Z (I) ::!"'D
m m m (I)
r- 0 0 (I) 9 O::D
:.a t -I -I > Z "'D - -I z-
~ > -I -f m 0 - zO
..... U; en o Z 0
I 0 -I Z 0::U
S co -I ~
co (5 ::!!;
~ 01 (5 0
0 -I Z 0",
." 0 > 0 mm
~ 0 > ~ -
::u r- Z ..J
r- c
~ -t ." "'D -0 -
~ :I: 0 ::D ::D
~ m ::D 0 0 000000
Z ::D 0 0
~ m m m m a::-o(l)~a::-o
)( z m m mr-~>mr-
-t C C OC -IOC
>tr Z ~ (I) :I:a:: m:I:a:: 0
~ ~ -0 "'D (I)
(I) m .,,~::u::u::u~ m 0 0
~ -0 ::l 0 ZZ:I::I:-Z ::u z :I:
:! m ID -t >(i)00 (i) 3: -t m
::t
~ 0 () (5 r-."oo ::u ::j it' r 0
-t 0 Z -"" - z c:
0 a. zc:c: r-
~ al ~-o-o 9 \I m
z ~ m 0
~ N ." ~
... 0
~ :I: ::u
m
~ 0 0 .J)
c: b
::u 0 \1(00000
<
(I) m "
:t! z ::D t (i)',," ." 0 ~
> z >;u;u0 0
Ro C (i) ~mm3:(i)
~ ~ _-o"'D-o~ .JI 2
ifi!;!;!;c
~ z >OO~:;;
~ 0 _mm _ ~
!" ::U"'::D r- -4
-1-_ r- i
(l)Z Z m
-I~ (i)
~
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File
2. Gold City
3. Yenow Applicant
..
l' \ 1 5
\i \ \ ~ t.." "'-l5 J
Ir-- \
s~
ZONING (office use)
5537 -=l
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
r<\. \A.V\ \ oS \" G v.. f t ct
11l1S W\\~""I\D~.5 IV'\
(Phone)
~I J.J.o3.<<{( b~
(Address)
S~
APPLICANT
(Name)
CULLIGAN WATER CONDITIONING
6030 CULLIGAN WAY
MINNETONKA. MN 55345
(Ad(B&2.t 933-7200
(Phone)
(Address)
Ir
(City)
(Zip Code)
(Contact Person)
(phone)
APPLICANT SIGNATURE
DATE
1-J,l.O
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain 1 Water Softener
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 $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $ d DO . () ()
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~<1 .50
.50
St). 00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildin!! Official
Date
Paid b{), (JV
Date r: II / ()
iptNo'bB1as-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372