HomeMy WebLinkAboutBuilding Permit 03-0809
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CER Ill' ICA TE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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~: ~c ~ I PERMIT NO. /\ 7 - O&Ot0
3. Yellow Appli.... U,..) 7
(Please type or print and SiKll at bottom) ,
ADDRESS
'SCl3-c; hn ~ {I~ F 'Vh Dr- laL. ~ f\J tJJ3/L..,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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OWNER \, I. L - 11 .
(Name) I...JY!. -( a.W1f. (90 l'lIS (phone)
(Address) ~3-C; {)n~ ~Y1C-t / Thcw- kt..t: MkJ t:;~5LL
. BUll..DER f\ _L ("{' , Cd
(Name) ,:"x~n~~ r lCilab.M" ~ I n9l, \ 'f1 L .
(Contact Name) 17;-17'( ~ V- (J
(Address) dJ (Ph . 72d ~ S~ fus+ I --4CU'tp\ov) t N kl
C(SQ-4tJ-7- S(\ R 4
(phone) ~)5/.~. ~2Cr3
(Phone) tt=51 . 7 L\~ qS-
'J'J~)
OAddition
ORe-Roofing
OAlteration
~e-Siding
OUtility Connection
1 rr~ 0]
o Misc.
CLOSE FILE
10/28/03 MP
lDeck
) Fireplace
OPorch
~CT COST IV ALUE (excluding land) S
I hereby CCI Nhich is to the best of my knowledge true and w....~t I also certify that I am the owner or
authorized agc:nl1Uf un;; 'W'.n"-IU~"'V'_~ yw.-u, _._ ___ _ n___.cuction will conform to all existing state and local laws and will...".....J 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
ent~er pon thCij'~perfO~eeded inspections. \
X '_ c, -rWqAQAT M~o41q, LlJ~lg IZt03
Signature Contractor's License No. Date
Permit Valuation 2/ S?)(J - cJV I Park Support Fee # $
Permit Fee $ 7<1. 71- SAC # $
Plan Check Fee $ ,-' Water Meter Size 5/8"; }"; $
State Surcharge $ J.,U- I Pressure Reducer $
Penalty $ I Sewer/Water Connection Fee # $
Plumbing Permit Fee $ I WaterTowerFee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
-
Gas Fireplace Permit Fee $ TOTAL DUE $ -/&.(/1/
/to. vU /)
This Application Becomes Your Building Permit When Approved Paid Receipt~o. ~5b
Date &./'1 O~l By "1 .
0
Building Official Date
This is to certify that the "'quest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may r-. _..J as "'quested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows constnlction to commence. Bero", occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions, if any
24 bour notice (or all insoections (952) 447-9850. (ax (952) 447-4245