HomeMy WebLinkAboutBuilding Permit 03-1062
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom
ADDRESS
170dl r('sl.
LEGAL DESCRIPTION (ollice use only)
BLOCK ~ ADDITION
Date Rec'd
l. White File
2, Pink City
}. Yellow Applicant
ZONING (offic,"",)
LOT
OWNER II . ,\ .
(Name)_5-"4tl.c..tN'L~
(Address) m
BUILDER 0 ,....., 1-
(Name) ,:)ufY'"\",,:t$,'rG -t"re>hJl (10lr--
(Contact Name) ~~"""~l ""2u:<.K~
(Address) 73DI Co
a
'6-,;<9(,- 603
(Phone)
(Phone)
(Phone)
I"S/- 2'5/- /'Xgo
losi 25/-1"0
TYPE OF WORK
o New Construction
ORe-Siding
DLower Level Finish
DMisc.
DDeck
DPorch
ORe-Roofing
o Fireplace
~on
OUtility Connection
DAddition
. I AA
I
--
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 all construction will conform to all existing state and local laws and will proceed in accordance with
submitted p 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 upo e p operty to perform e d inspections.
x
Signature
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
~cil'~ 9/107
c.. -()? r
?-5 -c(5
Date
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 'f'f,Q3
I Rec#o.~sbI8
0' .
Paid
Date
'll/Ii-.
.2-. (ll
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.
Planning Director
Date Special Conditions, if any
24 hour uotice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
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Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
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T~ PAtJT.
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which Ls proposed at:
Jrz()~1 ~~ Rd
Accepted Accepted With Corrections ~
Denied
~
Reviewed By: ~ ~ Date: oj; I (o~
comm~ent~: (!.t.t.( tfn ~;e /. ~fk~ o;/~
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"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid,"
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