HomeMy WebLinkAboutPlg Permit 01-1067
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICA~~~ COMPLIANCE
AND uPu I t7~RMIT
~. ~i~i: ~::y PERMIT NO. /"'\l- /0" 7 I
3. Yellow Applicant ~,
(Please type or print and siJtll at bottom)
ADDRESS
33QO (, /V11 '~/{/fk/"
,
Iva,'!
ZONING (office use)
R;)..
LEGAL DESCRIPTION (office use only)
LOiJ?BLOCK~ ADDITIONI1()~1 -UXJ.A .)&~
C/U' -
1-I/JP11PS
PID~5 -~~~ . ttJr~)
OWNER
(Name)
fA.! ~,,1 ~ 141/J VI
(Phone)
(Address)
BUILDER
(Name) f/lJfl,,1St11~1,,1
(Contact Name)
(Address)
1.f1J1A1 t' S
(Phone)
(Phone)
TYPE OF WORK
o New Construction
o Deck
o Porch
OAddition
ORe-Roofing
ORe-Siding
OLower Level Finish
o Fireplace
OAlteration
OUtility Connection
~Misc. fA/ a-lf'1"
c "
'/ f7T'If:'~1 f1?/'"
PROJECT COST IV ALUE (excluding land) $
I hereby certif'y that I have furnished information on this application which is to the best of my knowledge true and correct. I also certif'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 proceed 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
ente~;e property to perform needed inspections.
X . .V..f ~.( L/ Lfhlt/(, q -:2.f, -d
., Signature Contractor's License No. Date
This Application Becomes Your Building Permit When Approved
I Park Support Fee
I SAC
I Water Meter Si REQUEST FOR INSPECTION
I Pressure Reducer SENT TO CONTRACTOR. NO
I Sewer/Water Cor RESPONSE - CLOSE FILE
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid LfO,() [)
I Date a-d.~ -u/
#
I $
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $ .!;O
Penalty $
Plumbing Permit Fee $ ,,~9,bO
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
$
$
$ L/otOO
Receipt No. 40 b d--(;..
By ~
Building Official
Date
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