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Home My WebLink AboutPLMBG 07-0979 Oak' Rec' d \I~h I d f,trhe~S 1 Blut' File I PERMIT NO ; '~:~w ~~ltcanl . 0 T () q 11 ZONING (oHice use) (Please LEGAL DESCRlPTION (office use cmly) LOT BLOCK ADDmON PID (Address) (Phone) [L1 5" ~) 4'-JD - .- ((PI J. ~ 7Jo - 497- q/~G (1;1/1 '753 *;;A (Phone) ( q <; c1) L( +-Y - () dw 0 '~ C/ h OvV\ h 4 C; ~ ; ViA Yl. 9; 3 I i I (City) (Zip Code) OWNER (Name) APPlIC AN't 11/1.. 1 S r? (Name) u." vlL'l;1)n r wMe'l (Address) l < D . r? 0 'I- 7 I 2., J (Address) (Contact Person) {Jfi(Vt l+uSh~~ (Y]1lz:- (Phone) APPUCANTSIGNATURE DATE PLEASE COMPLETE BELOW Quantitv TVDe of Fixture Quantitv TVDe of Fixture Bath Tub with or without shower Rough-ins Dishwashcr Watcr Hcatcr Floor Drain Water Softner Lavatory (Bathroom Sink) Stand PiDe (Washing Machine) Laundry Tray (1 or 2 ~ompartmcnt sink Sewagc Eic~tor Shower Stall Backflow Assemblv Sinks Backflow Assemblv Test Dar Sink I Lawn Sprinkler Water Closet (Toilet) , Other FEE SCHED"lTLE industrial, Conunercial & Multi-family 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50 Residential, Additions & Alterations $39.50 Estimated Cost $ I L\-"1.5' ~ Building Pemlit # PLUl\1lBING PERMIT FEE $ 3'11)0 STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ i1 o. - (orne;> US{' Only) This Application Becomes Your Building Permit Whe-n Apprond BIIUdlne omdal Dale Paid 4-0.0 0 Dote,o ,ta ~Ol eipt No. 5" +e Z5 24 bour notice for aU inspections (952) 447-9850. fax (952) 447-4245 16200 Eaglr C....-ekAyl'.. S.E., PI'ivl' Lak\', MN 55372-171"