HomeMy WebLinkAboutPlumbing Permit #12-0899 � O ❑� C� ❑��0�❑ � O > =c�
n � S�3 ��� 3 m�c� = � � n0
� D o �� 7� 3 r 3z� Z t� �
lG � � m m y ITt N � z> Z O y O'�
� � "� "'� � - m � � � Z �
b v n H � � Z Z 0�
� � A D O P Z mX
o m
� O � Z �
� r v { `�✓
_ � v �
� m � o o ❑0�0�0
'� x m m m m� �
� � N c c
� ^c Z � o o ���� W m n c�
� C � ��'o .,�.� yG 3 � m
� r�0o � �
��
� � o Z 2� Z � C
z � m ���° � v
� A �
� 0 m _1
� � c� 1" �
� y °< `�o❑o❑❑
y = � �it'?tn� � �
R' v � N ���� M m
D m �
� n >mm�� �
� m "�Z� r m
-i � 4�
pRz Date Rec'd
O�, ° `��:,=;�.:k
,, �.., �-, �� � CITY OF PRIOR LAKE PLUMBING PERMIT
�.��
;:��
��: �
: ; �,w.
�
�. B�� File pERMIT NO. r�p
2. coid c��y �� —� b 7 y
3. Yellow A�licenl
lease e or int aad si n at bottom)
ADDRESS ZONING (o�ce use)
33��- 5 �A�,���1 S. vU.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER I/
(Name) �� �'^� �'�QC- � f�0"tV � Q (Phone)
, (Address) 337� SyGa�,�.,or� T't� J. �•
APPLICANT C �
(Name) ��a �� a �f � �u v�,b ( � �l � �in C . (Phone) 1 J Z, �-ro Q G� � a �
(Address) 8 S� J` Z ��"� J`�'� . W. �- 0.��U l( C� � M IJ J"r-,c-J O 4�
(Addzess) {City) (Zip Code}
(Contact Person) M�� �2 {Phone} � 52 �I -C�� G R Q q
APPLICANT SIGNAT ` DATE S`� ' � Z
APPLICA EASE COMPLETE BELL)W
Quanti T e of Fixture uantit T e of Fixture
Bath 'I�xb with or without shower Rou h-ins
Dishwasher � Water Heater
FIoor Drain Water Softener
Lavato athroom Sink Stand Pi e ashin Machine
Laund Tra 1 or 2 com artment sink 5ewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Cioset Toi[et} Uthex
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a$49.50 minitnum Residential, New One &'I�vaFamily $149.SA
Residential, Additions & Alterations $49.50 ,
The Minrtesata Statutes § 32Gf3.1Q8 ��st $ $uilding Permit #
"SURC.I-IARG�" has been changed for one
ycAr effective PLIJMBING PERMIT FEE $ ��� 5 �
.D�,t,Y d� 2�Y1), anti€ 3u�te 30 2a� i. STATB SURCHARGE - $ 5.0 ��$ '-'
The minimum surchar�c 1'or a fee" pern�it TOTAL PERMIT FEE $ 5� - � 5 O
is �i, be£innin�; .Iuly 1, 2010 - -
This Application Becomes Your Building Permit When Approved Paid �,` �� Receipt No. s��
7' /
Bu;ldine ot'�cial Date Date (� /� �� By
Q
24 haur notice for all inspecHons (952) 447-9850, fax (952) 447-4245
4646 Dakota Street 5.�., Prior Lake, M�nnesota 55372