HomeMy WebLinkAboutBuilding Permit 00-0994
It'lease tvP!: or print and sign at bottom)
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
If - )'7--()O
1. While File
2 Pink City
). Yellow Applicant
r PERMIT N9' 00 - 0994
I
ADDr!!g~ ~ 8~T1
LEGAL DESCRlPT}ON .offise.-1lse only) A
}tJ k,{5 0"1 traC r,-
LOT BLOCK ADDITION
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OWNER
(Name)
(Address)
BUILDER
(Name)
(Address)
PID ,;;5- /ob- QYI-O
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(Phone) 95'2 - '1L/?- 'I/o?!
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ORe-Si ling
r.Z L SUr /..letl 1:1 3?:>
(Phone)
ODeck
OPorch
ORe-Roofing
TYPE OF WORK
o New Construction
o Fireplace
[]Addition $lAID~2>n}-- OUtilit, Connection
PROJECT COST IV ALUE (excluding land) $
OLower Level Finish
Misc.
ZONING (office use)
R/5D
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also cerf y 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 pi Jceed in accordance with
submitted plan I am aware that th~;fficial can revoke this permit for just cause. Furthermore, I hereby agree that the city, ,fficial r a designee may
;terupon pp. ttytoerJn 'l?ectlOns') f l) I J / J /tffJ
, Signature " Contractor's License No. ---.lif ~ate
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
$ /'1- -;!r
$
$
$
$
$
$
$
Park Support Fee
SAC
I' ,:;)~
Vvater Meter
Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Vvater Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
This Application Becomes Your Building Permit When Approved
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Bmldmg OfficIal
11- J'7 -QU I ReceIpt Ncj. "1 K' t, --V
I fa.O U By tf--1
. ,,is IS to certtfy that the request m the above apphcatlon and accompanymg documents is In accordance with the City Zomng Ordmance and ma~oc2 requested
Date
I PaId
I Date
ThiS document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a eer ificate 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
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