' 12l1212012 03: 13IFAK 7634773629 1�002/004
<br /> � ` r � I
<br /> I �
<br /> ' It.'f.,'YPlE'US$'ONLY
<br /> � ~�-��� c�cy or��000 ���. ��.��. ':���'� : � aa�a– ia 3 q
<br /> ,'O�'��Q�� h.0.Box 66 •"patF•Rt�cOSvqd'•. :.-... .�'Pdmit 9 �,
<br /> � .{,. �� 2750 Kclicy Parkway ' •'''.• •''>•.':'. . C DD
<br /> ,a �Zd ' �I �rys�l lisy,`MN 55323 ��►pp�l�.e�`�1y;:•.. YR�pount$: 7. .
<br /> � ' . .
<br /> ���i�,y� (952)'249-4bt10—Main
<br /> 1,,. � (:952)249-4616—rs�t
<br /> CYTY O�F OkIONO—PLUMBING PERMIT
<br /> j (All Commercial Permits Must 'b'e Approved by thc State Prior to City Approval) �
<br /> ` � la� revA ,. df
<br /> II i►tt ://ww�r.d '.ntn, v/C.CLD/PD
<br /> F'/ c lunnb
<br /> ... .. , . .. . . . �
<br />' U�;N RAL 1NFO�Rlv1,a1�'I4N' � ' ' '
<br /> I.I You may apply fvr p�umbing pctmits by mail or in person at the City offices. Applic�ttions will be
<br /> revicwcd and a permit will be issu�d within two working days.
<br /> 2 Permit cards will bc sznt by retum mail after a r�view is completed. PERMITS ARE NOT
<br /> � VA1.ID UNTII.YOU RECEIV�,A PERMl7'_ WO K U T B�; N NTIL H
<br /> 1'E;RMIT CARD iS POSTED Q THE JOB Cr'CE.
<br /> 3� Plumhing per,nlits may be issued�ONLY So licensr,cl plumbin�;eonuactors and to proporty wners
<br /> � � ' residing�o tlie�dwolling. �
<br /> 4� Whcn any ncw eonstruction or remodeling is involved.a separate building permit mus�be
<br /> I obtained_
<br /> with State Codc uiremcnts.
<br /> } f � , ,,.�� �� ��, F��i wo����s7 bfe,done�n accordance �1
<br /> 1;.; " _; ;. ' `;�.^.
<br /> �, �I wd I dss be inspected and air tested be�t'ore it is cover�ed. Ce�ll(952)249-4600. i�' .?'
<br /> (24-48 hour notice required) �
<br /> � � � '��iF�E:�'��R�;°. --j �i.�k is,F'an�c:,e� —__
<br /> . .�� � . �
<br /> .. �
<br /> i ' ^_iyy pf F N6°n .� � '�'ys�l+�`ik'/�T��`•.�1�l�..A ���r
<br /> ) , . .
<br />. .;r� Y :. , .. . .
<br />� `�„1 �. .. . 'C, � ._ ._.'l�.Certl , ...,,: ..__.. .,.._..
<br />��� , � �75:1'C' :;x'�� '� .
<br /> .`��51d�9'1SIa�`r;at+ i �'(,Ori11'�1CfC1A�(A�fOVSI�e(�u1P�), ' �-_ ,,"t�n i e , ;
<br /> -` 9;7 �� .<�(�., , _ _....._, ..__.. _. ,.
<br /> 8y', a5i 7'� ,�.y nR aIPS R place
<br /> _ ..
<br /> ❑�New U Additio�nal,��� � r fi`�'--��. ''' �''';�1��D, k
<br />� � �� 'i � , ..; . � �: ,y��,y,i =��, �,�K�.l 'I.�y� tr �. �' . ,a;�rr v�'�i
<br /> ❑I 1►y ACccssO '��nacture?
<br /> �; ,• � � 78 i �e IV
<br />� '
<br /> : � ' d,�n �,need C-l�. �raOrono Ci�y Codo;.!�h�it�'._._,�_.__ _l_.__.
<br /> _ .__ _ __ Fwill- � �,�r�si rovt��a�i �y — (
<br />,
<br /> r
<br /> �Ul
<br /> . , it rTs�'�,� t,�:': >,
<br /> �. ._
<br /> __..__ � .
<br /> Job Site/Owner�Inforrri�t�orr: �
<br /> , -c
<br /> ,
<br /> � �sr��; i:.. . r' upl.. '�C.� �+�� :'t'
<br /> t' 4 � �.�.M� 5)�. . ,.� .'V�4P� �f'.�� •
<br /> (� � .
<br /> Slt� Ac#d�es�. r . . .� . .__ Y A'+ ,
<br /> �';��� ;;Jit � C' !�i� _� "`�'��� � ��`�,:.� ".� ��,i k v ��^��T.r i'���';
<br /> r .
<br /> _ ,, . r
<br /> ?'If, 4 ' � ; � ` ' ?:�.' 'h/j ddress:
<br /> O�net'-� " .. � � ., aili�tg A .
<br /> IS, �1' '�:1,; '�f(� .:1�Y-: f'h� 7!tllk?c
<br /> : r
<br /> 4. ;S1I � W,- :4t11Q� P;; �.
<br /> Cit� _„ , , „ �•:�.,�.,., � . .
<br /> �� ���r,�s ��,i:��:
<br /> , , . :. �, ,,.- , cr ��F :n�,• Alt�rh�ate Phone:.
<br /> , Hojme Pho�B. ' � �c���
<br /> � , . �,. ;
<br /> i, �. ,r�� ;,.�.; � ,r:�. ,,r , „ r��cc ;_
<br /> .� .. ..
<br /> Cajntroctor lnformat�rnt: " ' __ _ _ _-
<br /> ___..w. _,. _ ..__—_��j .!M p�
<br /> i• 'a �' !t o`i
<br /> �'� Cdntr�lcror: � � ' �� Cor�o�Person:
<br /> . ._ _.. _. _. _, _...__ . .:_
<br /> ._._ �. __. / ��
<br /> _-. - _ . �G.�a �;s�� c�: �: ���
<br /> Stat��Bond#: �'
<br /> �c�idt'�s�:'� '�"
<br /> G�y�'� �17� ' ;a"Zlp:� �x�it�atinn Date• ._' .b��
<br /> � . � .
<br />, ..1 �; `;,. '",`1`��' . .��d " 7$' Alt�rr►ate Phane: �
<br />,
<br /> F'lao�� � ., , .
<br /> _.:.. _. . _ _._
<br /> __..�._.___.._� ._ __.
<br /> � :,;;� , �.:� ���n�., ��►; ��. Insurance–Currcnt:
<br /> _ ._._.
<br /> ... _ .; ..
<br /> r �' •
<br /> ,
<br /> 0 �
<br /> I — ;
<br /> i� ,
<br /> � � , � _
<br /> ,..� � ' , N. ....._ _. .
<br /> .._i��.� �.�.Y�-4� . � ' tl _' - ��._' l.. ... ......___•___...._.... .
<br /> ,. _....._. ..�.- 1�� .-., . ...� .
<br /> i , � ..
<br /> IF , � �,_ 1 .
<br /> �r •i �. � 1! '. ���. .. �.,.
<br />� . ' �.�f � ! �-C�� Ae'k .. .. ..,.«.,.... ...... ��..,.__..._ .. .
<br /> ..? i I �.'� ...�,..� r-�-•� _ ti.. 4........,....
<br /> ;
<br /> ,., � ..
<br />, . .� . , � _. ._., . ._ .,_, ..
<br />
|