HomeMy WebLinkAboutBldg Permit 01-0585
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ADDRESS
<;ITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
J. Yellow Applicant
5Jf95 rJ2 rO()/~C' /J J_
U J (0;' y-
LEGAL DESCRIPTION (office use only)
LOT ;q BLOCK 3 ADDITION~6./Jo~ M.1J!o
~~e~R lYJ;cJ1~t1v
(Address) \.) ('L./Y}'lj2../'
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
lJCL/ I Mtl /l/
CLOSE FILE
10/28/03 MP
t.(lfi
(Phone)
(Phone)
(Phone)
o Porch
ORe-Roofing
OAddition
OAlteration
ZONING (office use)
7</
PIDa5- odl-031-2J
1/'15- 8' /1
-EI~Siding
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 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
enter upon the prope~e~orm needed inspections.
Ym~, I100~')1I0 In-- ''"A--O)
Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I 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) $
$ /'t 75"
$
$ l'dS-
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
Paid
Date
7(0,00
Co//3JO/
I /
#
#
#
#
$
$
$
$
$
$
$
$
$ 7~~OO
Receipt No. :'S 9 If /(;1--'
fF
By
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