HomeMy WebLinkAboutBldg Permit 01-0820
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I PERMIT NO. t)f/zo
ZO.I"lN7( ce use)
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1. White File
2, Pink City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS \
I L.ll J.'1
Br;~1
R\~ t~~ (
tL~
LEGAL DESCRIPTION (office use only)
LOT :, BLOCK -Z- ADDITION
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2. ;; - 2f34 0Z0-c
PID
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OWNER
(Name)
]:~r-b \ I
qCj l ~ 114v" 6 ifd-- J
(Phone)
(Address)
BUILDER
(Name)
(Contact Name)
Aw~~
A\I/;4.~t
6fe:J
~(l(
s\o{ ''')
lr-.'!\- HIt:, -Y90'-(
\N/~S
(Phone)
(Phone)
SS'351
(Address) '1391)
G~~ld /vv(
5.J.
We-Roofing
OAlteration
TYPE OF WORK
I Porch
ORe-Siding
CLOSE FILE
10/28/03 MP
]Addition
OUtility Connection
~ (excluding land) $ 1.1 0 0
o Misc.
I hereby certifY that I have furnish,,_ ________..n .. _ 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
~terupon 7J~:~t:perfo27~~#S' ~ IOd-I, CO - / -0 I
j:/ f~r,\ SI~~/1/1 ^\ Contractor's License No, Date
V
I Permit Vaiuation
I Permit Fee
I Plan Check Fee
State Surcharge
$
$
$
$
$
$
$
$
$
Park Support Fee
#
25cQO. -
14. 2.-<:
{ 1..7
$
$
$
$
$
$
$
$
SAC
#
Size 5/8"; I";
Water Meter
Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid tP- 71~.-
I Date B/I lor
, .
#
#
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
7.e:,~ -
Receipt No. 1/0:30 7
By IZ-LJI-r
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.
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Planning Director