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HomeMy WebLinkAboutPlg Permit 02-1032 CITY OF PRIOR LAKE 19] UUl 08/21/01 TUE 09:07 FAX 6J24474245 ~.. ~~;;' Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT I. Blue file PERMIT NO ~ 1, Gold City. . #'1, 'I - .I't) 3 '. 3. Yellow APpllWlI L/'::r- (Pltase type or minI : gd SilU'l-'lt bottOm) ADDRESS I r-r 2&"7 ~l1rshP{elcj ZONlNG (offie~ use) 12~ LEGAL DESC: : lPTION (office use only) ~ . LOT X'IlLO" 1< ~DDITlON ~€u~ Lf-t1- bt<:, \~(1r)n (\JQJA-7CT Y .. \ ' -_.-' 11U7 vVbrshf\e)6 (n sS ~urge w"tAr ~onrlitionin.a 12201 Minnetonka Blvd. WJ~~~a. MN 65300 (City) (COilt'" Pe""" __m K~I~ -tau II i /->- (Phone) APPLlCANl'tGNATUR!! 7J;:J{f(~:' !eLf DATE APPLICANT PLEASE COMPLETE BELOW Quantity _, 'I 'Ype of Fixture I Quantity , Bath Tub With or without shower :pishwasher :' Floor Drain . LavatQry (Bathroom. Sink) -' LliUTidry Tray (1 or 2 compartment sink , , Shower Stall -- Sinks Bar Sink . Water Closet (Toilet)" OWNER (Name) (Address) APPLICANT (Name) (Address) -- ~-- .._.~,_...........-.---, Ln~ Pill c?- G- ,~rr O;)..~ ,-() (Phone) OfS7- - 9S'S ,/ J-- 7 Z_ - (Phone) CIS 2 -Q3'i< - 18''25 D (Zip Code) <6\ ru) lee{) 2- st FEE SCHEDULE In"""" "I. Cool, n.",lo\ " MulMomily \" n(jnb ,n~ wllh' $39.50 minimum R""""tial, New 0.. ... Two-Family S99~U Residential, Additions & Alterations S39.50 Estimated Cost $ Building Permit # PLUMBING PERMIT FEE $ STATESURCHARGB $ ToTAL PERMIT FEE $ ~l 0 (Q) ',- .so '-to . 'J U Da~ Paid 1-(6- .;.- Date _ g, ~(;}C- J- Recet) ~7/() By~.../J ~. I vr~ ;J ~I !.~:'",\', ',: ';}:': <>:;-), _,.___.,~,__.. _ 1 !,..~.:' / ~.:';";n 10"1 Becomes 1:'our Building Permit When Approved ~ -,-" ~- .-- ftl'~"~1 g Oflle.bl 24 hot'" notice for an inspections (952) 447-9850, fax (951) 447-4245