HomeMy WebLinkAboutPlumbing Permit 09. 0474 O0 0 000000 z0
§ n 0 \\ 2 jk rn/ m o\
R rn m m 2r�§§) z $ g-o
- qa 2 $ �Q�Q 0 2�
k co 0 § / . 0 /
A \® o n z o x
$ 0 `\ §k m rn
-1 �
z }0 \ t `* 000000
x mmm c -o®5E� �
2 ® &° c � 0c 0c
Xa.m=■ -13 n @
2 M z / m A. ta ■» m 0 2 ° >0000 2 k ( m
0 \ - _ 0 � Z77 ;3 z t §
/ z 71 m r - - o -o P m
= m
o 0
0 .0E000 C-\
] z X2 § z ^�� ..
v
< Q "� -013 §2 i
% 0 �kk§K
. A 70 .n ® � a
p � � - E k. c
¥ r 0
,s~ _ CITY OF PRIOR LAKE PLUMBING PERMIT
v JUL 02 2009 IJ
NNNEse
I. Bile File
2. Cold City PERMFT
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/6%29'1 SI-e ),
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) . 0 I/ � ro'L✓'P (Phone)
(Address) ( (0791. 5 vY\ N LJ
APPLICANT 7 ( P ) (77 1 " 3( . `1
(Name) (—Cc-VG( +/ � � � G-- hone J
(Address) 2C)C0( Z. mon roe- 57` red v- m v s's-O I
(Address) (City) (Zip Code)
(Contact Person) (Phone) ( 3 ' 3 3 Cl& c l
APPLICANT SIGNATURE L%t J DATE 6 2
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher Water Heater
Floor Drain _ Water Softener
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (I or 2 compartment sink /Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water , loset (Toilet) Other
if) i' v/g f_ tA yr tS - � _ (Woe° 7“)
FEE SCHEDULE
Industrial, Commercial & 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 $ `-{ 9
STATE SURCHARGE $ .50
TOTAL PERMIT FEE
50, UU
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid Receip o. 51.7/7
Date �J By
Bultdine Official Date '
24 hour notice for all Inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372