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HomeMy WebLinkAboutPlg Permit 02-1273 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT ;0. '-I. VL- (Please type or print and sign at bottom) ADDRESS ZONING (office use) 1- Blue File PERMIT NO 2 Gold City 'OZ-/2-t'2 3 Yellow Applicant ~ ~ (Phone) S ~_ ~ ~_~ ~~.6.--- DATE /~_u.,~ ~~ICANT 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 I Sinks REQUEST FOR INSPECTION Bar Sink SENT TO CONTRACTOR. NO Water Close RESPONSE - CLOSE FILE MA Y 2003 Building Permit # 0 l- -I z... 7.J 3~--.SZ> .50 <q() ,;(/V , S~~3 ~ J \ /'J tAJ;;J;; -J .1<_ - - { LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION OWNER (Name) . (Address) APPLICANT . ./ ' .-----: (Name) ;:y .~ l? 0 I.. >t' /./A &.} ~L'?L~ 'It.) t.- 1;> / //r - (Address) ~ 7 ~ ~ R 0 ...L? -- (Address)' , (Contact Person) . ~ ~ I APPLICANT SIGNATURE Quantity Industrial, Commercial & Multi-family 1';10 or JUU "U~L "'au" "'N.~~ ....Uh___ Estimated Cost $ PLUMBING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE (Office Use Only) ~ PID (Phone) (Phone) .7 ,1.<" /;i.~. , (City) <x~ ?.<,< 7 (Zip Code) Type of Fixture I 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 $ $ $ paidtjO,;vL) ReceiPt~~J09 / Datez . / By ./1 ' r O-'f" J'Z- /.--- /1' 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 U - 16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714 Th;, APPUCation~ Yon, Bn;ld;ng Pe,mU When App,oved .nild;lfllbl I ~:,f -u1-