HomeMy WebLinkAboutMeter Changeout 01-0821
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
<See 2COf
I. White File I PERMIT NO
2. p;"" C;<y .0
3. Yellow AppliQllt
q'lease ~ or orint and sion at bottom) h
ADDRESS
/5"3>07 W tt.O< ~i2-~
LEGAL DESCRIPTION (office use only)
I~
LOT Co BLOCK (., ADDITION 10E.NNSN\AtNr-J
PID
OWNER
(Name)
~~
~~~
(phone) ~ ~ I ~ 40<;.. ~ 4-4-00
S:-~ I rEf '2.Clo ~(p ""^-' IV! "-I ,,;- J ~ "t..
OLower Level Finish 0 Fireplace OAddition OAlteration
OMiSC.~~~S-~'.#.O"'6nlk- 1cJ~:I{PROJEcrCOSTIVALUE (exdudingland) $
I'
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 OWDer or
authorized agent for the above-mentioned r-~1"--i and that all construction will conform to all existing state and loca11aws and will proceed in accordance with
sublDltted 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
e~17f1J:P1tUIIi.= ~ b L
~r~ s~re . ~ I Contractor's License No. ~'
~"--A1/~ ~I'/O/ tt;.(z.-;;V~'7c;;.z.e;
I Permit Valuation ' Park Support Fee I #
I Permit Fee S SAC
I Plan Check Fee S Water Meter Size 5/8'(V
I State Surcharge S I Pressure Reducer
Penalty S I Sewer/Water Connection Fee
PlumbingPennitFee $ I, "u....~.-!! FilII
I Mechanical Permit Fee $ ~ :... -' ro' ~ u...
I Sewer & Water Permit Fee $ I-...........~.
I GasFireplacePennitFee S I I TOTAL DUE
Thm~W;;j;;i
I BuildingOffidal .~ _ ~~,
(Address)
uJ €N S rv\ "'\NN
10q~
BUILDER
(Name)
(Contact Name)
(Address)
_0 )
rJ- !)J~
(Phone)
(Phone)
TYPE OF WORK
OPorch
ORe-Roofing
o New Construction
ODeck
#
#
# '($'-
I Paid
I Date
~
/ tJ lj,(/V
<l"r/~{)'
I ~~!f~~'
"
ORe-Siding
OUtility Connection
S
S
S
S
Sr
2.50, -
70,-
IZS..... )
45-)
15"0, t:1o
LID Of)';
)~
S--
S
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 .....r~.....J Certificate of Zoning compliance and allows __..",_._.:.... to .....__._._. Before occupancy, a Certificate of Occupancy must be
issued.
.
Planning Director
Date Special Conditions, if any
24 hour notiee for all inspections (952) 447-9850, fax (952) 447-4245