HomeMy WebLinkAboutBuilding Permit 03-00481
(Please type or print and sign at bottom)
ADDRESS
5520
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
L/~ 28-{)3
I. White File I PERMIT NO
2. Pink City ./} ? - 0 A-Cl/
3. Yellow Applicant U...;> -r 0
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'7'/tA- J
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
BUILDER f/.../ L - f.J..
(Name) I ()~.- ,(/ U y rc.x.v j,'
(Contact Name)
(Address)
9s'"'r6 d1at./tJ Sf
TYPE OF WOF
CLOSE FILE
10/28/03 MP
o Misc.
(Phone)
.
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(
(Phone)
(Phone)
ZONING (office use)
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PID~ ,. a31- oofR-O
c;sz ~/ :3606
. ,
~e-Siding
DUtility Connection
I hereby certifY that. .__. . :h 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 propeny a.u~ _._. .on will conform to all existing state and local laws and will proceed in accordance with
submitted PI::~ aware that the b ilding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
~teruponAo~,rmne inspections. t;~2-g-CJ 3
Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
z. ro 0 ,C/D
$ 7d7j
$ .r--
$ .J. l- (
$
$
$
$
$
This APPIZ!l~CfflS Your Building Permit When Approved
~ f'V6'd]
Buil mg Official Date
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o Porch
ORe-Roofing
# $
# $
$
$
# $
# $
$
$
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ReceipjjJ:er.' HZ. z, 7
By :J-._
o
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
:place
OAddition
OAlteration
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
COST IV ALUE (excluding land) $
Park Support Fee
SAC
I WaterMeter SizeS/8"; 1";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
I TOTAL DUE
I Paid -J fA . 0 0
I Date . tJ, . :z4-0?
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