HomeMy WebLinkAboutBldg Permit 01-0046
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/- 25..0/
(Please type or print and sign at bottom)
ADDRESS
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO.O/_ ()~4{p
~(,f8 1f!.,()JII~ teo 5.6.
ZONING (office use)
'€/SD
LEGAL DESCRIPTION (office use only)
LOT 5" BLOCK I ADDITION tJ,4Kt.fi tJ 0 8e:;Jt!#
~~e~~ra IZ1lJ!o-r
(Address) (JJh'l?; 1eu6ftu &.. c<E
PrIOr
PID 25-/t.fO-005-0
. (Phone) Q52-,1.2/tJ -LI5go
J-ah/ /?1/!/ 65372-'
BUILDER -ra / / /Orh7Clt/!...e Cons lruC:l7i)n
(Name) I u.. Vf' . (Phone)
IJ
952 -Wi}-g-yo
(Address)
TYPE OF WOF CLOSE FILE
10/28/03 Mp
OPorch
ORe-Roofing
DAddition
DAlteration
?e-Siding
DUtility Connection
o Misc.
PROJECT COST/VALUE (excluding land) $
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 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
;"'XI;;;:;Z'1!'::f~'"' . 1-;/6 -01
. Siptatu# Contractor's License No. Date
Permit Fee 1$ 7+.7S
Plan Check Fee 1$
I State Surcharge 1$ /.25
Penalty 1$
Plumbing Permit Fee 1$
I Mechanical Permit Fee 1$
I Sewer & Water Permit Fee 1$
I Gas Fireplace Permit Fee 1$
Building Official
Date
Park Support Fee # $
SAC # $
I Water Meter Size 5/8"; I'" I $
,
I Pressure Reducer I $
Sewer/Water Connection Fee # 1$
Water Tower Fee # 1$
I Builder's Deposit 1$
I Other 1$
TOTAL DUE $ 7".00
/1.
I Paid '1~. 00 Receipt
I Date I"'Z~--ol By
This Application Becomes Your Building Permit When Approved
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and ma 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