HomeMy WebLinkAboutBuilding Permit 03-01042
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please tyoe or orint and sign at bottom)
ADDRESS
i./ 3 <is S (J t)/IJr-adn S+.
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER J l
(Name) Dn IV IV,/ r:
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
I. White File
2. Pink City
3. Yellow Applicant
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I
TYPE OF WORK
CLOSE FILE
10/28/03 MP
--
I L...JMisc.
Date Rec' d
PERMIT NO. ()3- /t>l~
ZONp!!:J,ffice use)
PID~S- DO~-()/1iO
!JarvleLL (Phone) 95.d- -#7-' y'6~/ ..
(Phone)
(Phone)
o Porch
1tRe-Roofing
OAlteration
ORe-Siding
OUtility Connection
I hereby certify that I have furnished information on this applicatIon Wll1\.... .u .0 the best of my knowledge true and correct. I also certify that I am the owner or
authoriz ent for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submi d p s. I am aware that~.e b . ding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a de. signee may
enter pon e operty to perform ded }nspecti~ns. /? .
X c:t I~ e?>~'-t:5C~'O~~
Signature Contractor's License No. Date
1./ V
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
-;::)StJO, --r
$ 7t../~ /.J
$ / ;' d-)
$ I
$ I
$ I
$ I
$ I
$ I
This Application Becomes Your Building Permit When Approved
Building Official
Date
OAddition
'/VALUE (exc1udingland) S
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
.. ----
Paid ~ !&,,,~
Date a- _ I ",-1A ~
V' ...g;...- w. -
# '$
# $
$
I $
# 1$
# $
$
$
$ ~1t:7. 00
I Receipt No. .tluiKi h
Bv /l"
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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