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HomeMy WebLinkAboutPlg Permit 02-1034 CITY UF t'lUUt\. LiU\r. OS/~1/01 TU~ 09:07 FAX 6t24474245 Date Rec'd LI1' i OF PRIOR LAKE PLUMBING PERlVlll" , ' I. n1ue fi~C \ .r'1oI,~.,1\""T NO . ~d ~ ~~~ · '. t 3. Yollow MP\lWlI _ f) }.- )63 '-! (Please we or llrlnl : lld, si?,l1 at bottOm) ADDRESS .. ~ Cl 0L\(o D_~~:ielcl })r . Sf: , ZONING (offic~ U$e) RI LEGAL DESC\: IPTION (office use only) LOT viI BLO( :K I ADDITION " .~" '(l{J-?~ ' /!A (') n D J2 "~-+S(( A~I\ C~\ \ ~ / (Address) :J0'6{"O 1-<(J,Vlbclr9~r. F-,Ion I APPLICANT (Name) ~urgo Water C..:."dl'iivfliIIY 12201 Minnetonka Blvd. ~~a8f~~rG\, IVII\! :>o~Uo (City) (Cout.dPersO" }~~ .Z<d..YLLI.' (Phone) q ~> L . APPLICANT 'L ONATURE~ . '~.-f:=~i i ~ DATE APPtrtANT P~ASE COMPLETE BELOW ..... Quantity__ Type of Fixture Quantity , Bath Tub with or without shower ~ pishwasher ~' Floor Drain .. La'latQry (Bathroom Sink) Laund.ry Tray (1 Qr 2 compartment sink , : .Shower Stall . Sinkg Bar Sink . Water Closet (Toilet) OWNER (Name) (Address) - --' .._...'............~..---. PID ;;;S":2;i?--tJLf (- <) <4 S 2- .q~S~ . 727-/ , c._ (Phone) (phone) 9:5 2' ,q --:S?r - l~kO (Zip Code) CI ::s p" I PC'O <6/ 2-0/u ?__ . 'line) , VUl"" . \ FEE SCHEDULE ,..,j"", ;,1. emi, 00",1<" & MuIM",,;!y I % or job co" wi"" $39.'0 mInimum R..id",,~"'. NeW 0.." Two-Family $99-" Residential, Additions & Alterations S39.~O '.-::-:',.,;', ',: .:,i:': {';:;;l Estimated Cost $ Building Permit 1# PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL FtRMlT FEE $ hlO CD - .50 4{)'~ "'Piid I fA 0:; G \ ReceiptNo. '(t/ I L!d 7,70 ~~ c7-d-P.r1 BY~__ ,._--"'~ -.....--.....,....,...,..,,-..--.-. - : ,;:: /. F;:1;':11 !ojll~et'Qmes 1'our Building Permit when Approved Date DlIk r,\~!.'!1 g IJflidsl 24 htl\\1" notice for all inspections (952) 447.9850, fax (951) 447-4245