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HomeMy WebLinkAboutPlg Permit 02-0278 CITY OF PRIOR LAKE PLUMBING PERMI. Date Rec'd J-~7-0 Z- u ~~~ANT lhMcm. rrul~V (Address) tlP1LfO l1/i!ln(lCJ Kttvl (Address) (Contact Person) C'-1 tnJ UJ APPLICANT SIGNATURE' - J ~ ,tlRt.L \UjKLV lj APPLICANT 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 Sinks Bar Si Water REQUEST FOR INSPECTION SENT TO CONTRACTOR. NO RESPONSE - CLOSE FILE ULE Industrial, Commercial & (Please type or print and si2ll at b.y..y~) ADDRESS bOlli\ tj 3}. 51lCI LEGAL DESCRtr uON (office use only) LOT 4-- BLOCK ~ ADDITION OWNER ---. (Name) ~.\ tlC\'-j (Address) r:s 9-\-) Cl KOCKCuJ ooJ nh" (br, (' D6 Quantity Estimated Cost $ / ~ Cl t/'fJ , .. PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ (Office Use Only) ~. ~~ ~:~ PERMIT NO.O'7...-o..,--?d. 3. Yellow Applicant e.- ~ I &II ~ t. ZONING (office use) PID 2...C) -/61- <<- -1- () _ (Phone) LfS91- ULI1-l-{Q>L11 (Phone) q03l- Llo0~ ~7l0 \0- (( L \ ILL CJL)Ul/l{ (City) (Zip Code) (Phone) DATE ~ 1A/C(2- 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 Building Permit # 0"2.." O"'l..- 71J m J'i. rCI .50 ~_d~ , This Application Becomes Your Building Permit When Approved ~ 1..-1,7,.,-z-, - ~ Building Official Date /' 24 bo., 0"'" to, .1I10.......~(902) 447....... Paidt/l.c.IV 'Z-- 7 ""f) z-. ReceiPt~) J7 By ;Y~