HomeMy WebLinkAboutBuilding 05-0735
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
'7. z 9. OJ-
I. White File I PERMIT NO I
2. Pink City . CJS- (l "'-1':1 r'
3 YeHow Applicant . ,
hx
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
-
IN..
OWNER
(Name) ---U..I\ i c....:v. t~ (? \
l) W.-" ~
(Address)
r'
'--'
1-
W \ J.3
PID Z5:ZCJ7. 005,0
(Phone) C,5l- 91::;- - 4 7~S
BUILDER tIIA I. \ -L, \ r .. I C
(Name)--!Y1.~ yll17V~CYV Ck\. ') '\:-"V~()~
(Contact Name) ~ h...\\16-~Vj Ih"p\.v L..;C.I k_
(Address) \'71)1-' r::: 1 "_'~'" ...', '
',- r:- \A- V............Ai ;.(,.
TYPE OF WORK
o New Construction
OLower Level Finish
(Phone)
(Phone)
,~ ,,)
On jf"
fl'".-.... ,...., ',;;.,. ".,.-..,. "... i
_..... '-- -~,r ,~- .7 ,_ 7-./
'7.:-::!- ~3;:' .'~ - II v:.j
,--"'? c).'Y".-'.~-:''''
1.~ ~- '-...., "-" t
~"
r~
/
ODeck
o
OPorch
ORe-Roofing
o Fireplace
OAddition
OAlteration OUtility Connection
F.- 1-, ",',
PROJECTCOST/VALUE (excluding land) $ . '.., - ~
V'I'
-::>;~ ""4.-....,,
I hereby certify that I have furnished information on this a plication whic s to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans, I am aware that the building official can revoke this permit for just cause, Furthermore, I hereby agree that the city official or a designee may
enter upon the ~~ to perform needed inspections,
X / ~:.,---;::;--z:-z-~ O'.JO 1.. 207 7- 28 _.;, :,-
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Building Official
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7h. (/ 0
,
This is to certiJy 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,
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Planning Director