HomeMy WebLinkAboutBldg Permit 01-0724
CITY 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
I PERMITN20/-7~
':/,//
///
(Please type or print and siJtll at bottom)
ADDRESS
Lj~Lft' C ~/d~Jl~/n
~J,
/
ZONING (office use)
1G~
LEGAL DESCRIPTION (office use only)
LOTLj BLOCK /6 ADDITION
PI~-(X)I-I ~4-()
OWNER
(Name) ~7Z.n)
~.
wl./,/-r'
(Phone)
(Address)
BUILDER rJ j /
(Name)<--./d~/;Vg.~.d-U ~ ~~/
(Contact Name) .~~c=. Oo":{/:'JoPIA-, ~~~ C
. . 1/../
(Address) It/tilt!: ~A:.' ~ <::;"
o Misc.,
CLOSE FILE
10/28/03 MP
(Phone) ~~ - ge;'""/ ,3yA'7
(Phone)
75 /;~"y/4-.
o Porch -- ~e.Roofing o Re.Siding
OAddition OAlteration OUtility Connection
VALUE (exc1udingland) S1'ddt? dO-
TYPE OF WORK
I hereby certify that I have .w......... 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 au CUIl,U u\.uv.. ........ conform to all existing state and local laws and will proceed in accordance with
submitted pia . I aware that th~b. .Uildin official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon I e to perform nee~' ections.
X ~./~. tJ~/.?9L( 7-/7-~/
--. - - ./~ture Contractor's License No. Date.
I Permit Valuation I Park Support Fee # $
I Permit Fee $ 7l///~ I SAC # $
I Plan Check Fee $ '. Water Meter Size 5/8"; 1"; $
I State Surcharge $ J" 8'5 Pressure Reducer $
I Penalty $' Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved
I Paid 7ft-,,00
I Date 7-/1-0,1
7bm
1'-/311
ReceiPt No. "'1 U Y'
By (.;w1./'
U-
Building Official
Date
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