Loading...
HomeMy WebLinkAboutSewer & Water Permit 10. 0411 5 0 Dc n O 0000 "0 0 a E0 a nn ■ 0 ■ -n - -n -n � 0 § 0 ■4 § a A $ § $ in >k�c§ M m k 0o © 0 a g CD -4 > 0 0 CO 0\ tTi > d z0 IQ W § 2 2 ` Cl) \ 0 0 . t § 2 q o .4 6 k § o » 2 2 ç m m q r o 3 I Z » 0 0 000000 m lir k -4 Z 0 0 \ mrR$mr % N 2 ? xa. mi .. '0 n - CO 9 2 $ ; 0 , § _■ ■ � § m 0 n * m A § > 090 0 2 -I m r -no w 74 0 Goa0 Z 0 m . ik� 0 .:=1:. IC3 Q. 2 i! 0 k / _ m 000000 �> z oz1zn - PI* � � g � � _� � a q s - 7 1 0 § ■ � r 0 05/24/2010 12:12 9524476169 KRUEGER EXCAVATING PAGE 01/01 .7./,‘940../ Date Rec'd CITY OF PRIOR LAKE L.,/ .i...__\N,,,, SEWER AND WATER PERMIT Villiippr r, NEso 1. Grern riM PERMIT NO./©- 4// i Vcflow �}ty PERMIT l ;, Gold Applicant (NNW n LVt7er print and Alpn at bottom -- ADDRESS ({ ZONING(office use) CX- LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER 42X0--- D /l� (Name) IL R (Phone) (Address) ` \CA $ , ' 0v Nic z , C\� , (Address) ' (City) (Zip Cock) APPLICANT) -r_ '«j- (Name) r t: cx,,.)0 �} o(phone) j " '-1 1 -$33 t 0 (Address) r15- -Alk �/ b I • ,V� \L G1-372- (Address) (City) ) C `,�1 t 915- .' 611-133 �15" (,�'� (Zip Code (Contact Person) (Phone) 1 P'— `t t^ 33 5 APPLICANT SIGNATURE / r-' DATE _ 5-A2 ( ll ,..- APPLICANT APPLICANT PLEASE COMPLETE BELOW _ Size of water service inches. Location of any couplings from structure 0 feet. Type of sewer pipe. [] ABC ❑PVC D Cast Iron { Estimated length of sewer line_feet. __ � Clean out(if required) located at feet from structure. FEE SCHEDULE Residential sewer and water line connection $51.50 Industrial,Corn'I&Multi-family I%of job cost with a 551.50 minimum Sewer connection only $25.50 Water connection only 525.50 p� av Estimated Cost $ ,yllQ bo Building Permit SEWER AND WATER PERMIT FEE $ -5-0 SURCHARGE $ .5Q TOTAL PERMIT FEE S t C ((Mcc Use Only) This Application Becomes Your Building Permit When Approved Paid OL Uv R ei No.6 037 2 Date s Iiuildlne Official Date c" ,---; a 1 —' 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 ' ` 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372