HomeMy WebLinkAboutPlg Permit 02-0160
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
2-/9-()2-
I. Blue File
2. Gold City
3. Yellow Applicant
(Please tv1>e or orint and sign at bv...u~)
ADDRESS
ILf045 Candtewood CircJ..L Nf
~~;~~ANT NorrJlOYYJ PLumrJlna
(Address) J-q 05 f1 Of f1 'fLrJ .Av-i [;i).
(Address)
(Contact Person) l_ JB:ff ~ I tJYV1
APPLICANT SIGNATURE OtrmrYL---
~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom S REQUEST
Laundry Tray (lor 2 c FOR INSPECTION
Shower Stall SENT TO HOMEOWNER. NO
Sinks RESPONSE - CLOSE FILE
Bar Sink 4/2003
Water Closet (Toilet)
LEGAL DESCR1r HON (office use only)
LOT BLOCK
ADDITION
OWNER
(Name)
L1Jri 0andt
\.~ a6 {))JOY&
(Address)
Quantity
PID 75-2/5 -004--c,
(Phone) (tj52 )41/5- Wf~
(Phone) (LP /2) ~7-L/D33
J mo/s. 5510'1
~ (City) ;: (Zip Code)
(Phone) (I.R/~) SI)7,*'-!037
'- /
DATE ~lg...LoJ...
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
tand Pipe (Washing Machine)
ewage Ejector
,ackflow Assembly
;ackflow Assembly Test
.awn Sprinkler
,0ther
J4.1!..I!.S\...I1.I!.DULE
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 $ ...:?JDO . ~ Building Permit # a z - 0/ (PO
PLUMBING PERMIT FEE $ ",. 5R
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ lHJ . '!!-
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Vl1A~ z,ltI/() 2-
~: Official Date
pai'!4-0 ~O 0
Date
Z-Itf~ ()7..-
Receip~/2-3 4-
BY?-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245