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Plg Permit 02-0919
08/21/01 rUE 09:07 fAX 6~24474245 CITY OF PRIOR LAKE 19Jvvl Date Rec'd ell'i OF PRIOR LAKE PLUMBING PERl'.o.l I, DIu. File PERM! I 2, Gold City. T NO. AJ/'J.-ChCJ 2. Yellow Appllemt {/ /'I -'1 I (Please we or nrinl : ad si~ at bottom) I ADDRESS " ~ \'7:~3:).'..". ~~'J~ (~n. ZONING (oftice\lse) 'RI - LEGAL DESC: ' IPTlON (office use only) " . LOi5'~LO;K I ADDITlONJJ.'PA~ -I ~':~R ~jJ.SR l-b.r+nYL (Address) _" ')..Qe~() KQJ1..h{ i d~e r9 }1lcJ PID d;" 3TJ - o3'--J/"? (phone) rt- ~/()O Of Sd . q PL:? . '7::;..7) - (phone) _ APPLICANT (Name) (Address) Sill'ge water conditioning 12201 Min~tnnk~ RI\ln. "4~a, MN 55305 (City) (Zip Code) (Contact persoo k" dJJ--! Q.J.l J.. LL I . (phone) q S ;;l . q 38 . IP?F?O APPUCANT:, GNATURE ~~~h.b.L DATE .~. ~ U .-~ APPLICANT PLEASE COMPLETE BELOW 1 ype of Fixture I Quantity . Bath Tub with or without shower '~ Dishwasher '.' Floor Drain . LavatQry (Bathroom Sink) Laundry Tray (1 Qr '2 compartment sink ': Shower Stall Sinkg Bar Sink 'Water Closet (Toilet) ;., Type of Fi1tUTe -Rough~ins Water Heater ~ Water Softner I ~t~nt\ 'P;ne (Wall:hinl1 Machine) , CLOSED WITH SF BLDG . - - PERMIT PER KELLY AT - - SURGE WATER CONDo , 2/25/03 Quantity .....--. ' , FEE SCHEDULE h,d,"" "'. eml, ,,,,,'a1 So Mu'U-fomily 1 % ofJob '001 wllllO $39.50 miol1nun\ R.,.;dot>UaI. N... One So Two-Family $99.50 Residential, Additions & Altl:T8tlon$ 539.50 Estimated Cost $ JQO - Building Permit # _ PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ un cP - .50 H{).~ nlJ~!~'l; g 1J(1lclnl r Paid lit) ISO . ReceiPtlr;~ G, <? _ -D"'[_;}(,:o.~. By ~ 24 hOllr notice for an inspections (951.) 447-9850, fax (95l) 447-4245 .... r:-":~,~':..:, :J::.: {,::~.~.). ~._--"" -.,.....~_... - .. : '!.:,)::, /, !,,~~;';ll !Oll Becomes 'VQur Building Permit When Approved , ..., 1 ! Date -.,. ..-.----" ..-......----..--