HomeMy WebLinkAboutBuilding Permit #03-1248
(Please type or print and sign at bv"vm)
ADDRESS
see:;
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White File
Pink City
Yellow Applicant
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LEGAL DESCRIPTION (office use only)
LOT lfBLOCK Z-ADDITION f1k...lIJIZ/IIltA./
OWNER
(Name)
lLev j ~ A l2e:~
(Phone) Cf~l - t2(... ,~-t.>z.
(Address)
BUILDER
(Name)
(Contact N
(Address)
CLOSE FILE
10/28/03 MP
TYPE OF
o Misc.
I hereby certify that
authorized agent fi
submitted plans. .
enter upon the p
x
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
(Phone)
(Phone)
ODeck
DPorch
ORe-Roofing
L--I..............-- -~
o Fireplace
OAlteration
o Addition
PROJECT COST/VALUE (excluding land) $
/J
Date Rec' d
9.17. 0]
.
PERMIT NO. () ? -IL~ t
ZONING (office use)
IC-{
PID -zS-: 17 7. oZ.1 ~ 0
ORe-Siding
OUtility Connection
is application which is to the best of my knowledge true and correct. I also certify that I am the owner or
perty d that all construction will conform to all existing state and local laws and will proceed in accordance with
ng offi aI can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
inspe ns. q ~ 7 13
Contractor's License No.
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid ?&. c/u
I Date ~ II . 0 S
This Application Becomes Your Building Permit When Approved
Building Official
Date
Date
# $
# $
$
$
# $
# $
$
$
$ 7&'- 00
RecttNO. ~,(j
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