HomeMy WebLinkAboutBldg Permit 01-0721
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7- /7 ,.a/
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO. 0/- 072-/
(Please tvpe or print and sign at bottom)
ADDRESS
562~ ev.OSSANO~ S/I~bl
ZONING (office use)
PUD
I LEGAL DESCRIPTION (office use only)
LOT ~BLOCK / ADDITION ~//VA--t- I€/O~ IS.,
PID 2.S~299-0oB-O
OWNER
(Name)
(Phone)
(Address)
BUILDER -"--J C' \ -- / "'
(Name) ('~ ~rJ
(Contact Name)
(Address) ~3~S-O - l.&~ Lu~
TYPE OF WOF--_......,," ODeck
(Phone) I:l d
(Phone)
I~LA
. tJ
1// t{- <6 if tI '7
~s-t)l/si
/
~e-ROOfing
OAlteration
OPorch
OAddition
ORe-Siding
DUtility Connection
CLOSE FILE
10/28/03 MP
~lace
o Misc.
COST IV ALUE (excluding land) $
I hereby certifY tha :h is to the best of my knowledge true and correct. I also certifY that I am the owner or
authorized agent for the aOOVe-ll1CUuv,,~_ r - -. _ on 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 MIS permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to perform needed inspections.
x
Signature
Contractor's License No.
Date
I Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
12,SOO,OO
$ 74.7S"
$
$ {. zS-
$
$
$
$
$
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I $
I $
'$
I
'$
I
'$
I
'$
I
, $
I
'$
I
i$
#
#
#
#
7~. 00
(/?'/ a J
J
This Application Becomes Your Building Permit When Approved
J2JP~. 7./'7.() I
. Building Official Date
7~-OU
l-r7~ 0 ,
Paid
Date
I Receipt No.
I By or./
o -
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