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PLMBG 05-0862
Inl .L 1 .;;.uu...... .L.A........' THIS FILE HAS BEEN CLOSED DUE TO INACTIVITY 4/18/2008 Date Re~.d F PRIOR LAKE PLUMBING PERMIT 9 (; .(is- ; ~~ ~:~ I PERMIT NO. oS 0 &ttJ z-l 1 Vella"" A,.,elulll , . 50(/ cA 5~c-/'<. C,. /"'<2 /-e- I ZONING-'~l LEGAL DESCRIPTION (uftier U$l: only) LOT BLOCK ADDITION PIO z.ti, qlO. 0/5.0 OWNER (Name{~"'7d- ,A>:? ~/'re/-= (Phone) ?&~- Y;f"b- 2?.9o?, ~c-"n.5a4- ~ ./'7,v SSe::-;/? APPLICANT (Name) 5L:.-<2. 5' ne v /?:lea' ..-5~.n ,C! ~,....,;z::?/? <<- (Phone) .5f5::;L .75?r-~~ , (Address) /VAi!4-'/?-__ v--e.-'~,z....-- ,S~ '7/ (C' ) (Zip Code) (Contact Person) (Phone) 96"';> - 7..5-;,9- /O=-C DATE P'3~5'~ Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough- ins Dishwasher Water Heater Floor Drain Water Softner Lavatory (Bathroom Sink) Stand Pipe. (Washin~ Macbine) Laundry Tray (t or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow AsscmbJY Test Bar Sink / Lawn Sprinkler Wilter Closet (Toilet) Other APPLICANT PLEASE COMPLETE BELOW FEE SCHEDULE Industrial. Commel'Clal &. Mul1i-family 1% of job cost with ll. $J9.SQ mil1imum Re.sidenual. New One &. Two-Family $99.50 Rosidential. Additions &; Alterations $39.50 . C-l:;) Estimated COit S ;:? 3 6 Building Permit # PLUMBING PERMIT FEE S STATE SURCHARGE $ TOTAL PERMIT FEE $ 395c;, .5Q ~av (Office U.e O.ly) This Application Becom" Your BuildioK Permit Wb.rI Appro\led Uuildln~ Of1ltlAI D".. Pald1'O. (IV ale 1.'7 {;J . Receipt NO'#9...?? 8y '::' 14 bour notll:t ror all hupel:riqns (95%) 447-9850. fax ('52) 447-..:t45 16200 Eajtle Crtlllk Ave.. S.E., Prior LlIluf. l\1N 55311.1714 TOTAL p.e1