HomeMy WebLinkAboutPlg Permit 02-1605
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
OWNER J
(Name) Farao. vonatrltU1
v -
(Address) ,~ ('AllcLlfWOod Lan~
~;;~~ANT NOr~IOYY1 PLumb{na
(Address) 1A 05 aM f1' -t-l d /W J L~ O.
(Address)
(Contact Person) ~ ltff 1\ If){ l? I oYYl
APPLICANT SIGNATURE tfl-f/ft/L---
I ..
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom SjnJ..-l
Laundry Tray (lor 2 c
Shower Stall. REQUEST FOR INSPECTION
Sinks ~hNT TO HOMEOWNER 2/03.
Bar Sink NO RESPONSE. CLOSE FILE
W,terCloset (Toilet)
(Please type or print and si~ at buuum)
ADDRESS
Ctu1dleVVDod
141L-fL(
LEGAL DESCRIPTION (office use only) (J
LOT ~LOCK;A ADDITION ,&t;/YJrl
fJ+
Quantity
I. Blue File PERMIT NO .~
2. Gold City ..11 1_1. j OJ
3. Yellow Applicant Vc:t fe'
L-IU1 &
ZONING (office use)
PUo
/jUt
PID~5-
(Phone) (452-) LfL/5 - OK'DI
(Phone) _( ~ I~) '61/7'- ~O~ 3
rn pr<; .sS4 O~
, (City) (Zip Code)
(Phone) (l.r?/,l-) rr~7-'-Io~3
DATE I~I JSID2-
Type of Fixture
,
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
ewage Ejector
ackflow Assembly
ackflow Assembly Test
awn Sprinkler
ther
J4.1!.ES'--III!..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 $ lfOD. ~
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
BuDding Official
Date
Building Permit #
, ?fI.52
- .50
LtD. ~ ..
."
Paid 1./01 ()()
Date
19,JQ -(J ;}.
Receipt No. /U
.lI~ '1 -"
~
24 hour notice for all inspections (952) 447-9850, fu (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714