HomeMy WebLinkAboutBldg Permit 01-0730
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7-/7-0/
(Please type or print and si5!;ll at bottom)
ADDRESS
5930 {)~/o~6
f? t.-.
1. White File
2. Pink City
3. Ye\low Applicant
LEGAL DESCRIPTION (office use only)
LOT to BLOCK Z-ADDITlON
OWNER
(Name)
. (Phone)
PID ZS"-'3/(, -()2A-O
(Address)
BUILDER
(N ame)
(Contact Name)
(Address)
JouW J 6JZ-
CLOSE FILE
TYPE OF WO 10/28/03 MP
(Phone)
(Phone)
ck
OPorch
~ ,
~-ROOfing
OAlteration
uw___fCOST/VALUE (exdudingland) $
replace
OAddition
ORe-Siding
OUtility Connection
o Misc.
r Permit Valuation
I Permit Fee
Plan Check Fee
State Surcharge
\ Penalty
I Plumbing Permit Fee
\ Mechanical Permit Fee
\ Sewer & Water Permit Fee
\ Gas Fireplace Permit Fee
'Z, ~. 0 i)
$ 74. 7~
$
$
$
$
$
$
$
--
/.z.t:'
Becomes Your Building Permit When Approved
cn"'Of
Date
I Park Support Fee
SAC
Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
\ Builder's Deposit
I Other
I TOTAL DUE
I Paid '7(,.1) 0
I Date ' '1,.; 17 () J
#
#
$
$
$
$
$
$
$
$
$ (&.oD
#
#
This is to certilY 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.
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
exnter u~~e~20/:~~erf,_02T _~ o"""e~~~d ~ iffi~p"c~diuu""'. . '// ~ f tJ J
~~' tr~ ~/d3)J<:' '~
C~atury Contractor's License No. Vate .J
- ---
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245