HomeMy WebLinkAboutBuilding Permit #12-1097 g ❑ O� C� O❑O�OO � O > Zc�
n �¢ a o 0 3 y z � °� m�
p G D � 7�0 �� 3 ��D,c�z� Z � y �'�++
ta � m� Ri y �zyZ O y p�
ro � n n� ,,, m 0��� Z o
�, oeOO n" (/� - n i Z Z O�
� C o ?C =� z ( m 7�C
'' m
� O D Z �
- � 1 r v �
_ �1 � 'fl
' �� p Z •'a n n ❑0❑❑❑❑
� m m m m ;�v�ng;v �
o� � N v o nc ��c 4
x3�mx3
'9 A � A
O N m '����� m � �
� e � m � Z� � � � m
� � � s �„88 ��, g
� o � � Zcc z r
o z � m �'°� � v
� A � �
� o � (�1
� y m �OOaaO ,� \
� Z z ��pZ' � �\ �
R• G ' y ��'�v� � � m
� m m�mZ� �
� m '���� s
N � — � m
4 R �� Date Rec'd
� � CITY OF PRIOR LAKE PLUMBING PERMIT
� �
�����
i: o� `��` PERMIT NO. ' �
or aud at bottom �. v�a� ��r�x � L'�Q /,
A,DDRESS ZONYNCi (ot�oe �ue)
.�'�5� �of/or��.,� L� LS�.
LEGAL DBSCRII'TION (offioe ►ue only}
LOT BLOCK ADDTTION PID
�� 5 � �� L �— _ c�h��) �?� d� • �4C3�
t � ,.5'`�70 Cc�ric��„ 1.r� S�, #/p5 ��io� , J�'!/�.3`�53� ��
APPLICANT RiCHF1ELD PLUMBING CO
(Name) 8640 HARRIET AV SO #10p (Phone)
BLOOMINGTON MN 55420
(AdBress) TEL:952.881.3355
UC. # 58325-PM , (City) (Zip Code)
(Contact Person) {Phone) _'�c'�r� � �g/• ��'��
APPLTCANT SIGNATURE DATE I �,�
APPLICANT PLEA5E COMPLETE BELOW
uanti T of Flature uanti T e of P'fzture
Bath Tub with or without shawer Rou h-ins
Dishwasher Water Heater
Floor Drain Water SoRener
Lavato athrroUm Sink Stat�d Pi ashi Machine
Laun Tra 1 or 2 com artment sinlc Sewa e E'ectar
Shower Stall Backflow Assemb!
Sinlcs Backflow Assembl Test
Bar Sink iawn S rink�er
Water Closet oitet Ott�er
Induatrial, Can►ncrcial dc Mulci-family 1�Ye of job cost with e Sng sp Cm�, �ULE � �� �&'i'wo-Family S 149.50
Rasidential, Additions & Alte�atioas 549.50
Thc Minncsota Statutes � 326B.I48 . �' st S�O� ��� $uilding Permit #
--
URCHARG� �� 0�g«l For one pLUMBtNG PERMTT FEE $
.ru�y �.2a�o untif June 30 �o� �. STA.TE SURCHA.RGE $ .
The iaisimum aurcMar$c for �"� ��,�'� �rmiC TOTAL PERMIT FEE $
�,'�. �{tnaia� J�Ny 1. 2010 . �
Th1a A n Becornes Your Building P When Approved Paid Recei t No.
���--� p 6 7 ..�
� Z� °�` 9//�/�� $y
.�
24 6our aotice [ur a!t inapectiona (9S2) 447-9850, !ax (952) 407-4245
4G46 Dakota Street S.E., Prior Lake, Mlnnesota 55372