HomeMy WebLinkAboutBuilding (Irrig. Meter) 03-1035
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
g - f. OJ
1, White File
2 Pink City
3. Yellow Applicant
I PERMIT NO,/'\7 It ~)r:-
L-0 c '_j ~
ZONING (office use)
PI./ L)
SD/~
LEGAL DESCRIPTION (office use only)
LOT / BLOCK
ADDITION
..-- /.' -" (' ~.. '7 ('
PID ~. Q'1;. I. .
OWNER
(Name)
?//J...TE
g./S
~/OiJ1 L5
(Phone)
(Address)
o-sJz. .
BUILDER
(Name)
(Contact Name)
(Address)
5An1 E
VI/2:f ;6 iA/;C# tt/)
(Phone)
(Phone) ~/Z. - ZZ/ - f'9;::::S-
TYPE OF~O 0 New Construction
'1 e:r&li o Lower Level Finish
MISCc' 4 0 - J I
ODeck
OPorch
ORe-Roofing
ORe-Siding
o Fireplace
OAddition
OAlteration
OUtiIity Connection
PROJECT COST IV ALUE (excluding land) $
I hereby certifY that I have 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
authorized agent for the above-mentioned property and that aU construction will conform to aU 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
;'" A th, operty" P' orm nw,,:z", $(, _ / ~ I &'~
Signature Contractor's License No. / Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; 1-\ $ :5r)O.60
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ -~ ((y. 00
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Paid
Date
5~;:a3
/
I Receipt NO.~d-/t;
By ~
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 constilUtes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
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