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HomeMy WebLinkAboutPlg Permit 02-1176 08~~1/01 TU~ 09:07 FAX 6~24474245 CITY Ul' t',tUVl\ L"iUU.' Date Rec'd CIT V. OF PRIOR LAKE PLUMBING PERMIT (PleQ$.(l we or pOOl : Ill! ~j~ Ilt bottOM) ADDRESS ~\ _ i tl3>5t-t V-ee-K~.\.eJ Vr:, SE ' l.D1ua File \p...,.....nTNO \ 2. Gold City .I.llnl. .. .TAA . 0_ ..., --- /17/- 3, Yellow Applloml C7' ~ r ZONING (ome. use) 'RA LEGAL DESC.: LPTlON (office use only) LOT~~BLO(K I "DDmeN ()JJk!f!.(/)duL ," ~ L - __n : V (.2. _ \ ~ tuY\ ( +20 I ~ '"Z- '/ n S )<- t (Phone) -~!). ~fMbyrdqe ~1: '~fZ() PlDd5- 37;2.- tJ LjLf-() J OWNER (Name) qs -2- 'Cf'6S 77 72- , (Address) (Address) Surqe Water Conditioninq 12201 Minnetonka Blvd, ~innetonk~ MN !1!1~n5 (Address) (City) (Zip Code) (Contact Pc<<o,:, ~"j iL.--\ fczU f4 . ~ (Pbone) CIS '2 .q 3f3 . /0W APPl1CANT:~GN"TURE ..~~ L(~J--!I _DATE APPLICANT PLEASE COMPLETE BELOW Quantity . Type of Fixture Quantity -:' Bath Tub with or without shower --, : -Pishwasher , Floor Drain , LavatQry (Ba.throom Sink) Laundry Tray (1 Qf 2 compartment sink : Shower Stall , . Sinks Bar Sink : Water Closet (Toilet) (Phone) APPLICANT (Name) , ...-- Type of Fixture RQugh-ins W steT Heater /, Water Softner l ^.. _ :J ......!_- I"''''__...L.~_..... '"i~I1'-~bine) - CLOSED WITH SF BLDG - - - PERMIT PER KELL Y AT ~ - SURGE WATER CONDo , 2/25/03 \ , .-l \ --" ~._- ---'" ." ........"'.......---.. - FEE SCHEDULE lil,j',',-,:.l ij'l COIL nerd,,1 & Multi-family 1 % (If job cost with a $39.50 minimum Residential, New One & Two-F&mily S99.S0 Residential, Additions & Altcratton$ $39.50 Estimated Cost $ Building Permit # PLUMBING PERMIT FEE $ STATE SURCHARGE $ ToTAL l'ERMlT FEE $ '-?/1 ' SO - .so 4o(j) , Date Paid t-(O, --- \ Dato tj _I q - ~ , I Receip.tN~ '3 t/;+ fl . BY.(/-G v ",,:,.-.\,,-;,,:,):,,{'<;:)' ~._--"~ -.-,_"'~"'-;--'"'-"''-'-' - ::";:::' V:<,;~,'1 lml Uet;Qm,es YQur Building Permit When Approved !)tl:~"11 glJfikbl 24 ho\\r notice for Iln inspections (952) 447-9850, fax (951) 447-4245 .. ._..________" ,_'____0"._._