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HomeMy WebLinkAboutPlg Permit 02-0357 08~~1/01 TU~ 09:07 FAX 6~24474245 CITY OF PRIOR UU{E LIl'i OF PRIOR LAKE PLUMBING PERl\o.l ~UUl Date Rec'd d- ---- I. Dlue file PE 2, Gold City RMlT NO. "'_ ~ /):2. c- A J. Yalklw APpllCU1l (./4 (/ -J..J -/1 LEGAL DE.SC, Lt'lJ.ON (office use only) , , ' ADDrI10N /QU!lr /kfJ (a./ c- ./J- 07q ~':~R :D f2 .~,~~v (Address) ~ 7b6w~,lrr'd'1/0~. -l!- frO =F._~L (HoKr lb.vOi~ qs2.q~ !J 2-?-{) \ ( vV\ '" f\t) eJZaJJrc 6R V' ~ . {}:1tk:o ~ (~dress)/- ) (City) (Zip Code) (ContactPe,,",,: "t'\~...+1 \q:,., ~. . (I'lIOne) C/SZQ 38 . /S'FQ P;PPUCANT!iGNA.TUJUJ~ ~4;t D,m 4)5(02- ! /, U . APPLICANT PLEASE COMPLETE BELOW Type of Fixture Quantity I , Bath Tub with or without shower " RQugh-ins : Dishwasher Water Heater :' Floor Drain Water _Softner --- LavatQty (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 Qr 2 compartment sink Sewage Ejeotor : Shower Stall Backflow Assembly S;nks Backtlow Assembly.Test Bar Sink Lawn Sprinkler Water Closet (Toilet) Other CLOSED WITH SF BLDG ~l!.1!.i SCHEDULE PERMIT PER KELLY AT Indtit.tli!'.l. COlli nerclal & Mulli-f~ily I % of job cost with a $39.50 minimum SURGE WATER CONDo 2/25/03 CPleue me or pnnl : ad siltn a.t bottom) ADDRESS ' ~, 5~oq ~Ol . prri) ~ - B 19 -Dcfl- () (phone) C1 S2- o/D5'7 2- 7: ~ (-aJLo f nJl,.,f LOT BLO( :K (Address) Quantity Estimated Cost $ ~ ; L-- Building PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ ~,.q S) - .50 ,~ P't/t1100 Date l(- J). ----O~ ~~>t~'''~~ ';J:~ {:':;;;:). ~'-._"'" -~"'-"'---'" \ T',':: /, F;:~bl !011 Becr.unes Your Building Permit When Approved f1.1!!~l!1 {: OUldnl Date t._ __.__._" -..._................ - " 14 hour nutice for.1I inspections (951.) 447-9850, fax. (9Sl) 447-4145 S5~S- Type of Fixture R~~8' BY~