HomeMy WebLinkAboutBuilding Permit 03-0722
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CER;rIFICATE OF ZONING COMPLIANCE
ANn UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
J 49 (1f)
LtJr-i
l. White File I PERMIT NO
2. Pink City . ^ J_ ./7 ") J-
3. Yellow Applicant (/.;;) . / if
1<1
LEGAL DESCRlJ:'uON (office use only)
LOT;t) BLOCK ADDITION t:;CL5fwCJod
OWNER
(Name)
.fJ~ct ~~ 80rKcJ
!'19J-O ~r-( teiL & G
(Address)
BUILDER
(Name)
(Contact Name) _
(Address)
CLOSE FILE
10/28/03 MP
TYPE OF WORK
o New Construction
ZONING (office use)
fGlSD
PID;;)6-IJ1-015."/
prt'-Or- LC{}:-~
(Phone) Cjg,. -'-fLf7-5~ I~
thAI &s37)..
(Phone)
(Phone)
DDeck
DPorch
ORe-Roofing
ARe-Siding
OUtility Connection
OLower Level Finish 0 Firwlace OAddition OAlteration
, o Misc. Replace UJ/N:1of)jS-~oJE~/cl;/;vfLUE (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 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
~teru{7~r~~ne{~)on~. ~ ~-b-D~
Signature Contractor's License No, Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
:;)5tJO, --
$ ,4,75'
$ ) ,~S-
$
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Park Support Fee
I SAC
Water Meter Size 5/8"; I";
Pressure Reducer
City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
.Paid -117 i,.--
Date 1...-5- ~
# $
# $
$
$
# $
# $
$
$
$ 'i~. tXJ
Receipt No, Liil5it!
By ~
U
, 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