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HomeMy WebLinkAboutPlg Permit 01-1423 CITY OF PRIOR LAKE PLUMBING PERMIT Date Rec'd /2-- ~,,()/ ~. ~~ ~::y I PERMIT NO./'")/_ /~_/ 1"'7 :<1 J. Yellow Applicant VI' /~~ (Please type or orint and sign at bottom) ADDRESS /13//r / l~t}thV Av.efJU~ AI E, / LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION &~~R ()~~h (Address) 1t./311 /7rn~iJ,.J/ Av~. tV 6. ;- - APPLICANT.. , bL -p b (Name) I\JOr lC/YYl llJ.-'W\'~ (Address) 2105 GuwJ1':e-JcJ AVe, So. (Address) ZONING (office use) Jl!...IS .0 PID 2.5-'130 - 0 B~" 0 (Phone) (9~2) L/17- 3328 (Phone) (It,IL \ a27-1~3s (City) (Contact Person) (Phone) APPLICANT SIGNATURE ~ ~~ ____ DATE APPLICANT PLEASE COMPLETE BELOW Type of Fixture Quantity Bath Tub with or without shower Dishwasher Floor Drain Lavatory (Bathroom Sink) Laundry Tray (lor 2 compartment sink Shower Stall Sinks Bar Sink Water Closet (Toilet) Quantity (Zip Code) 12. / I~ /0/ Type of Fixture Rough-ins Water Heater Water Softner Stand Pipe (Washing Machine) Sewage Ejector l::t.,,,lrfl,,,,, Assembly c\ssembly Test lkler REQUEST FOR INSPECTION SENT TO HOMEOWNER 2/03. NO RESPONSE. CLOSE FILE Industrial, Commercial & 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 $ 1 tJ7J ~ Building Permit # PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ 3'1.$""0 .50 If/). (TO (Office Use Only) This APp~ur Buildiug ;-;u;~;7'ed Building Official Date pai40 . 0-0 Da, 1-' 1-& . () I 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 ReceiPt~//lq By ~