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Plg Permit 02-0488
08<~1/01 TU~ 09:07 FAX 6~24474245 CITY OF PRIOR lJU{E 40 .6D ~UUl Date Rec'd Ll1. i OF PRIOR LAKE PLUMBING PERl'ut I. Blue file \ PERMIT NO ~. oold city VI ') _ /\:/ I c::> i1 J. Yellow APpllCJlll (,/ ,,( (...,1'""1 c> Jf (Please we or vnnl : lld .i1l'J:\ At bottoM' ADDRESS . - L7;)75 tJu/Lh. {l/"/ Dr _ u LEGAL DESC, IPnON (office use only) , . LOT/.?BLO~K ~DDrrION D~/eld $CLDI0d ZONING (offiee \lse)- 'RI pII1AS-37-:k 0&,6-(\) ar .1m1p,fJ(J.L{t%onH) ora,;}.... ot2:c; .1Yi'J- M~ hnn'dsf., !!!:' tJ-J12D OWNER (Name) : D R '..Jay4--r7(\ _l~tj dD8'0CJ . (Address) APPLICANT (N ame) (phone) ! Surge Water Conditioning (Address)' ~;'. t. GI J . - f / ('\\l.;lu'N5sM5 (CilY) (tJpCode) (cootod~eno~=K.'U&{ ).A.1 ~:1 Cf52 .Q38.fflO ~PUCANT ~ aNt.TURE tcfJ "V DATIl .JL-fib.-Io '- APPLIC T PLEASE COMPLETE BELOW ____i.. -- --.. ---- Quantity . Typo of FIxture I Q_tity Type of Fixture -~ Ba.th Tub with or without shower Rough. .ins :pishwasher - W8iCf)Ieater :' Floor Drain - I WitMSotlner La"atQ1'Y (Bathroom Sink) I ~h_ JI"'-- fn. 'ihing Machine) . LaundrY tray (1 Qr 2 compartment s CLOSED WITH SF BLDG: . : Shower Stall ' PERMIT PER KELLY A 1 nbly . "Sinks SURGE WATER CONDo iibly.Test . -Bar Sink ' 2/25/03 ,'. Water Closet (Toiletl___ . fEE SCHEDULE lnd\it.tl illl. COlli nerclal 8r. Multi.f~ily 1% of job cost with a $'39.50 minimum Residential, New One &. Two-Family 599.50 Residential, Additions & Alterations $39.50 Estimated Cost $ Building Permit if PLUMBING PERMIT rt.~ $ STATE SURCHARGE $ TOTAL PERMIT FEE S '?; q. . 5..f:. .50 i-f tJ . OD L,,_._~_. ,t:= ~.; itjtnclal Oak -Paid 'If), 00 Dato _." ~ 'Oct- . Receipt No. 7'\ ~ ( g{)U By t?C . G ... [_,,;;',~;,;'~~;';:';'\;;;' 11m BeclJJIles l'our Building Permit When Approved {,-::-:>.~':--:. ";J:t'.: r:':;;::). " 24 hour notice for .n in.peetions (!)S2) 447-9850. fax. (95l) 447-4145