Loading...
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