HomeMy WebLinkAboutPlumbing Permit 08. 0225 0 J i..
LIJ Z _ w ti c e
2 71 (� �Z UU W > c4
M WULL
� `-� ❑❑❑❑❑
V
W O x y�
rx o N Q
U. Z Si
w 0 z P z o °'
a. fa. 0
F - oot �. 0 N W
W Z x x Z? w c a- O- 0
x LL
a.
N 0 a. c.. g o o z _ - o
J yj W W W W w
L4.
a2 s N G. '2 _ Z oC cd
00000 0 a a o r
\ ° z J 0 W ft
1' o a
t- z Y W z Q : � ao ti
0 U c
xz o p w co a v = oc
a N A
ap N O Zo z W C a s o Q V
o cc w z 00 o a C ? z~ 2 O 0 O n U
U? Q 0 o. 0 000❑❑ V
cs / PRIO 4 Date Rec'd
ti \ CITY OF PRIOR LAKE PLUMBING PERMIT
U r' t=7
i N ES O � F '
S 1. Blue File PERMIT NO. (
. � '—
2. Gold City /� � , ,J
3. Yellow Applicant
(Please type or print and sign at bottom) r
ADDRESS ZONING (office use)
15 1d1 Ft 5\f. Pt\ -.. 5E 553 ea
LEGAL DESCRIPTION (office use only) •
LOT BLOCK ADDITION PID
OWNER (�
(Name) L r v1 p'C CW\ k\\ (Phone) G5 4 - 4 w 7 -SL 1
(Address) 1 5 1 ai`l rt 5L. P0s1,,-k 'ZS sc
APPLICANT CULLIGAN WATER CONDITIONING
IN
ilio
(Name) 730 CU�- (.1GAN WAY (Phone)
MIETONKA, MN 55345
(Address) ,;� (952) 933 -7230
(Address) (City) (Zip Code)
(Contact Person) (Phone)
DATE
L`
APPLICANT SIGNATURE &In l " (S - O APPLICANT PLE ASE COMPLETE BELOW
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 (1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) I Other
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 $ 00 . OU Building Permit #
PLUMBING PERMIT FEE $ L 'n , 5 O
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ s•O , QC)
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5 0 Recei 7� Z
Dat _ 3 L � By
Building Official Date `` •
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 I
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
.
.