HomeMy WebLinkAboutBuilding Permit 03-0449
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
~ ~/7--()3
I. White File I PERMIT NO
2 Pink City . If 3- 0 #a
3. Yellow Applicant (,.1.:/
(Please type or print and si2Il at bottom)
ADDRESS ZONING (office use)
3t!/t1<V 6~!sbr7 5~LL,f-
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
PID 7-~-/7z- {)/S-o
(Phone) ef7S:l- .yf/t'.. 4/88?
-loA", ~ ~~ /i?~
/
.5 f/GJ t/ L3~/s ~ _ <5"~~..j-
(Address)
RoN Cl>~ ~~U~/;d~ '.LNc::. (Phone) 962-8A~-&.!:> /$
4.......,k ~<." (Phone)~
/0 7 ~tJ L f//I/#4- /fJi!, So~, /1/ /lilp'7 },-1/4 ~ /11 AI .s- <:"~:ZO
, / /
TYPE OF WORK 0 New Con<tmrtinn ,,~ . ~h ORe-Roofing
BUILDER
(Name)
(Contact Name)
(Address)
o Misc.
OLI CLOSE FILE
10/28/03 MP
'ition
OAlteration
~e-Siding
OUtility Connection
I hereby certify that I have furnished in f knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-mention _____ .. _ wmvuU LV 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 property to perform needed inspections.
X :IStii,/Ut(/~ Ee233 '7 It'/d"/I/3
, S~ature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
2 SZ;cJ. (/V
$ "?t.1 75-
$
$ I,~
$
$
$
$
$
ThO APPlia7lJ?ll~ BWWillli P=U~"71 :;<d
Building Official Date
eluding land) $
Park Support Fee
SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
I Paid '7t,. (IV
I Date '..tI- .,-/7-0 J
# $
# $
$
$
# $
# $
$
$
$
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Recei~o.
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,
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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 notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372