HomeMy WebLinkAboutBldg Permit 01-0164
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
), Yellow Applicant
Date Rec' d
3- 9-0/
PERMIT NO. 01- 0 1(04-
.se type or print and sign at bottom)
ADDRESS
/ (p Z3(P t-AKF<=;/06 ,t:tV6 5 C
LOT BLOCK
LEGAL DESCRIPTION (office use only)
OWNER ~
(Name) ,\..... \ ~
ADDITION L-P~.J'IO~ Pff~
ZONING (office use)
K!.-I s;,o
~(\~(\~
PID 25"1flC" -0/4--{)
~'J\) "C-ee-
(Phone) I \<?)~~-J
(Address)
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(B~~~lI~r' f:-~~~ ~ \C)\ ~(\C)~~ \~Q\\S \ t\L (Phone) ~S~ ~CC~ -Gcn \l\
(Address) C\b6S \\ \J (Y\~ \+ .:f\~~ ~ \~~ \ ~~a \\ -
TYPE
CLOSE FILE
10/28/03 MP
-\1
ODeck
o Porch
ORe-Roofing
'ireplace
OAddition
OAlteration
PROJECT COST /V ALUE (excluding land) $
x
I Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
~e-Siding
OUtility Connection
rmatlOn Un UUo _",Aication which is to the best of my knowledge true and correct. I also certify that I am the owner or
property and that all construction will conform to all existing state and local laws and will proceed in accordance with
ding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
inspections. 96 f6 6 3 ~ q -0 \
Contractor's License No. Date
1$
1$
1$
1$
1$
1$
1$
1$
74-. 7~
I Park Support Fee #
I SAC #
I Water Meter Size 5/8"; 1";
Pressure Reducer
1$
1$
j$
1$
1$
1$
1$
1$
$ 1~.Q()
I Rece1l.p.l~o.
I By
I.
.s 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
wilen 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.
I Gas Fireplace Permit Fee
. 11
e es Your Building Permit When Approved
Planning Director
-
I . l.-~
Sewer/Water Connection Fee #
I Water Tower Fee #
I Builder's Deposit
Other
TOTAL DUE
3-'1-0 I
Paid
Date
7~ . r/V
'J .... c,.--, 0/
Date
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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