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HomeMy WebLinkAboutPlg Permit 02-1597 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIl I. Blue File 2. Gold City 3. YeUow Applicant PERMIT NO. ();;L" /S9?l ZONING (office use) R/5[) (Please type or print and silm at bv..u~) ADDRESS .?;'3 ,W ~~pn OO~ ~ &v ~ PID&5- (fttj- oot(--o LEGAL DESCRIPTION (office use only) /1 _ . LO).p BLOCK ADDITION ~ V g;.:::R~\\j' \ ~ [)~G'ie:h\ (Address) 3~ \4 Gv,€-eI\ ttel a~ --tQJ &J.) u - ~;;~~~ ~[,))'i: \)() U-el{ :to 1')) LDd-eR.. (phone) t lS - ~~ ~?<l 0/ ()-, (Address).~J~ ~j ~ R ~e I(JLI +nlnl8:Tl, [1")\ :)L/DIL/J (Address) (City)' (Zip Code) (Contact Person) ~ \ . (Phone) :] I~ -~81 o~0lo{ 0/ APPLICANT SIGNATURE \rY\ ~.h~ DATE -....J 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 Sink Bar "REQUEST FOR INSPECTION Wan SENT TO CONTRACTOR. NO RESPONSE - CLOSE FlLE MAY 2003 Industrial, Commerciial (Phone) told --;:;rao-EfYt8' Quantity Type of Fixture / Rough-ins Water Heater Water Softner Stand Pipe (Washing Machine) Sewage Ejector Backflow Assembly Backflow Assembly Test Lawn Sprinkler Other DULE _ ___ ~._... ~",.".J\J mInimum Residential, New One "Two-Family $99.S0 Residential, Additions" Alterations $39.S0 Estimated Cost $ Building Permit # Building Oftlclal Date ~4 .60 . . ..50 l..fO .D~ Pai~ L//J, 00 Date/J_lb_~ Receipt No. ('Y l/~'?Q}f B~ (J PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ (Oftlce Use Only) This Application Becomes Your Building Permit When Approved 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 \ /