HomeMy WebLinkAboutBldg Permit 01-0313
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1,
(Please type or print and si2Il at bottom) '1 Q () ()
ADDRESS C?'w () b-LI
':;~ ,,-
1. White File
Sfr'v-o l t. tL.~ ~. ~,t. f~;_
'->4. ~ ~ 1 'L.,.~ tJI~5
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
I'rl~ fl A~
OWNER
(Name)
~ \{<:lI\do\'r
(Phone)
(Address)
BUILDER
(Name) -
(Contact Name) ~~~ Lee. c.~1)<b"
(Address) 310 /~ A~_ Sw~ I/V. p,
TYPE OF WORK
o Misc.
(Phone)
(Phone)
tv1 r), S's {,() 1
ZONING (office use)
R/SD
PIDr~5-/33-(J~-Y'
4L/{) -2.s 19
6/). -Cl61 ' '-/;)../2
o New Construction
o Porch
~e-ROOfing
OAlteration
ORe-Siding
o Deck
OLower Level Finish
o Fireplace
OAddition
OUtility Connection
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 e above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. a aware that ~ilding official can revoke this permit for just cause. Furthermore, I hereby agree that;;:e city cial7a designee may
~terupon the opel r;:: -~deJ~~~ /3/81
Signature Contractor's License No. pate
J '
Permit Valuation'
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
PROJECT COST IV ALUE (excluding land) $
$ 7'1 IS-
$
$ /r J-5'
$
$
$
$
$
Pre reducer
I sewer/wattt- n Fee
I WaterTowe F
I Builder's D sit
I Other
I TOTAL DUE
This Application Becomes Your Building Permit When Approved
I Paid
I Date
If/} ,00
tI-/3-r~/
Building Official
Date
.~~
/-P-
$
$
$
$
$ 7 It, , 00
#
Receipt No.=sq.3 67
By ~
This is 10 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