HomeMy WebLinkAboutBuilding 02-0769
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
~~U.O~
I. White File I PERMIT NO
2 Pink City . 02 -""7 I' ~
3. Yellow Applicant . V _ '" L
102> Wi LbEetJESs. ~ I /J6 E R. ~ ZONING (office use)
!f>e (()-~ LA N S- -7- 2-
LOT
LEGAL DESCRIPTION (office use only)
BLOCK
ADDITION
PID
OWNER
(Name)
CJ-{ R. I S. (~ ~AA ~EN ') SI ~ 6Ebf:frE
(Address)
(Phone) 4~L '-fLf:J- 1~~7
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ORe-Siding
o Misc.
o New Construction
~ower Level Finish
ODeck
OPorch
ORe-Roofing
OUtility Connection
I hereby certifY
authorized age t r
submitted p s.
enter upon
o Fireplace
OAddition
OAlteration
ave furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
e above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
at the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
perform needed inspections.
x
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
PROJECT COST IV ALUE (excluding land) $
Signature
Contractor's License No.
b/~/o7-
Date
$
$
$
$
$
$
$
$
$
........
2 e>e>6.
$ (OZ, Co
$
$ JrOt)
$
$ (}.00
$
$
$
Park Support Fee
SAC
#
#
~?~-OL-
Date
I Paid
Date fJJ"71.( - 07
I ~;c~Ao. ~7.'TS~
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Planning Director
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE