HomeMy WebLinkAboutBldg Permit 08-0921
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
-S (te-q l.AJ bOJ.. cl~S:L~.h4 \. \
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
Date Rcc' d
II. ~ CiO
I W"il'"
2. Pink
Ytllnw
I PERMIT NO. oe. 012., / I
I FNlNG"m""" I
I
I
Fil~
City
^1\I)lt'.IlIII
u\....\.,,)
PlD
OWNER 11
(Name) 1N\.\e..~e I ~L9~.~-z.......
(Addrcss)__ l CS 1'='<1 uJOOb dcx:.....1c.. +V-Al\
(Phone) cq 5:;t-8s-s-- Y ~S8
t-...l\A.J
BUILDER n
(Company Nilme) ht4~e..... 5:.ei"u I~S:. l ~C-.
(Contact N~me) ~ t..J S~X
(Address) 1 c......Lt4 NA U S+- A t-)o(<:..A P-1,u
(Phone) 7~- 4~l-'7.;L ~
(Phone)? h ~ ~..cK?::! c9'-lSS
'S"s>o
o Re.Siding OLower L~vel FUlIsh 0 Fir(pIA~e
o New Construction ODcck DPorch <<Re.Rooting
OA jdlClon DAlteTiltion OVtility Connection
OMisc
TYPE OF WORK
CODE: DI.R.c, OI.B,C.
TYVe of ConstTlIction:
Occupancy Group:
Division:
I
E
n
F
1
Ul IV
H I
Z J
v
M
4
A
R
5
A
B
H
S U
PROJECT COST/VALUE S 6, S"Oo
(e"cluding land)
I htnhy ccrllly rhall h~V<' ~lInl$h..d Inlmmallon ~n Inl> appllcauon which 1I to the bnl of my knllwlcdge IIUt .\nd cnllCCI I Illll CI'II,IY U"t I alii t1\~ 1"""" '" ,\lIlh\Jnz~rt '1I:,nt rur Ih1'
lon'VL'.!Ul.!nIlOOt\1 PIl)\H'ily .'\110 111,\1 \U ~OIHII\lCrIOI\ Will conform 10 a.(J C.lll~ttn~ \talC :)(lU lOC1i1 l.\w, ~od Will J)lI'h.:ecd III ll.~L'~fIU~fHC! wuh \\lpmll\l.:lt pl..m~ 1 ,1m iJ,w,uC' that [h~ b\Jll(hn~
i "rnCI\lp~[ (~cn'''c Further mnrc. 1l1el eny AGree that the City OffiCIAl .\; :';~ Ih~ l"\)r,.ny 10 ~edllrm nct,c~ ":~u~08
L .e SI'Yl~ Cllnlrwur', Llccme No -~"[j~(~_'_'_'_"_u, I
Permll Valuation
Permit Fcc $
Plan Check Fee S
-::--_- 5
SlJre Surchaflll'
Penalry I $
I Plumbing Permit Fee .~
I Mechanical Permit fee \
Sewn & Water Permit fee I S
l' . I
~ G, } fireplace Permlt Fee
, S
~' Application BtCllmcs Y llut DuiJding Permit When Approved
I
..-...-.---......-
~\Ilhlllll! Olliellll
---..
Dole
Park Supporr Fee
SAC
#
S
$
S
$
S
S
$
#
Water Meter Size Sill", I",
Pressure Reducer
Sewer/Water Connc~lion fc~--"--#~
W(ltcr Tower Ftc
#
B\llldcr's Deposit
Othcr
TOTAL DUE
. 00
I Paid
Dart:
l~~--:~=..
_.~..
=J
fhn j'j ~u c,:rllfy ;hJI1l\l rdl\l....>;l 111 Ihl' .\\)tJvr ;'lJlJIi<.::111\ltl ;In;t;~'Urnpi1n~\I)~ (1U{llmcO(s I~ ill ,lCCllftj/l11CC will\ Ill\.' Ci\;.~~;17~'g ()n.Hni\nCC ,1nd mi\Y IlI'lKl'\.'(t.'i~ 1~C\\ll,.';.iI~'lJ ~h~U~\\I7H.:nl I
w/\t..:n ~J~nl.'d by Ihl.! Cd)' Pl;lllnc:r \1,II'\:)llIuIO.. tdmpVI,ll'Y Lt'ltiIlC,1tc ut' Zonmt.: l:umplianCl.' an~ .11l1\w1( \~\HI~'IIUUll,.IO {(j cCJmmcl1ce Btft)IC I)CC\lp.illl'''', ;\ Cl'lltlil.:iU(.' lit UCC\lptlllCY m'l~t be
1~\lll'd
I
Plunnin~ Dlr~elOr
nat~
'-'~i;rn;i;fl' lor all i1lSjltCIII11I, 19~2) ~4r;j~~ii. lax ('152) 447.4245
r0d0'd
Special f:t\lld!(I~I\L il.lny
lNI~W 3~~l ~Ol~d ~O All]
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