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HomeMy WebLinkAboutPlg Permit 02-1274 CITY OF PRIOR LAKE PLUMBING PERMIT Date Rec'd /0 . '! u 7- (Please type or print and sign. at bottom) ADDRESS 1. Blue File 2. Gold City 3. Yellow Applicant PERMIT NO. 02- -11-7J , ~<)x~ C-7Z (9 <: ~ ~.I7b lbffI ~~ ~L- ZONING (office use) APPLICANT PLEASE COMPLETE BELOW Type of Fixture Quantity Bath Tub with or without shower Dishwasher Floor Drain Lavatory (Bathroom Sink) Laundry Tray (1 ~-,.., ~~~~...rtm"nt "ink . Shower Stall REQUEST FOR INSPECTION Sinks SENT TO CONTRACTOR NO Bar Sink RESPONSE - CLOSE FILE Water Closet I MAY 2003 LEGAL DESCRIPTION (office use only) LOT ADDITION BLOCK OWNER (Name) (Address) APPLICANT J/ /"" (Name) ~~/. ~/7J..vi-lL//te/ Ck.~'-">~ (Address) S"7 '3 eJ::' JC:> ,4 ~ddress ) (Contact Person) ~Jt1 ,.,.- ~ ~ APPLICANT SIGNATURE ~ / / C-'/ ). ~.A .---- Quantity FEE SCHEDULE Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum PID (Phone) (Phone) 7,~- ";?}--6" ~~~ . (City) , 766,7 ~. ~""'D'~ (Zip Code) (Phone) DATE /0 L-,I 0 .~ Type of Fixture Rough-ins " Water Heater ./ Water Softner Stand Pipe (Washing Machine) Sewage Ejector Backflow Assembly Backflow Assembly Test Lawn Sprinkler Other Residential. New One & Two-Family $99.50 Residential, Additions & Alterations $39.50 Building Permit # 0 2. -/7...- 74-- Estimated Cost $ PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ (Office Use Only) 39. SZJ .50 4-cJ ,VV Paid 4-.0. cJV Receipt ~91.ro 1/ Day 0 ,. 4-. (JL-. _!J--I(. . U/ 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714 This Application Beco.-.es Your Building Permit When Approved fjf'y1t- { 6 ~ 4- dl Buillling Official Date