HomeMy WebLinkAboutBldg Permit 01-0877
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please !Yl>e or print and si~ at bottom)
ADDRESS
1. White File
2. Pink City
3. Ye!low Applicant
Lj):2.2 C<)jorO-Jc
~-I~
LEGAL DESCRIPTION (office use only) G__ /t
LOT BLOCK ADDITIO"l'1(7fJfL/N~fJi;;A~
OWNER
(Name)
.Tr 0"
4 J 22/
(Address)
13 e'Q ~
Cc /Orq do
(Phone)
5+,
BUILDER
(Name)
(Contact Name)
(Address)
go 1 rl C:"s/~c l'o/1
/Y)Q.r-J 30 t"
~~~O
TYPE OF WORK
Date Rec' d
PID }. ~ -- rolo-6 3 if -0
(Phone) 9~2 - L/70 -(,.t 7~
(Phone) S"ct....... e
C ~Q'" l '" 5.St!',., / ~4- ~f:' S'~ ,
AwJ'1~U~
C.~r-() b-
OPorch
ORe-Roofing
CLOSE FILE
10/28/03 MP
o Misc.
OAddition
OAlteration
'/VALUE (excluding land) $
~e-Siding
OUtility Connection
I hereby certify that I hay. _ n_ ____ -rr-----~.. .....~.. '" .0 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 upon th~~ to p~o~ n~ded in~ctions.
-/ / /-./(// ,.-/0/&1 '1bCJ -.8';).- '~h I $) Jt J 0
,A'ignature / Contractor's License No. / i5ate
Permit Valuation
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
$
$
$
$
$
$
$
$
-ttf7S-
Park Support Fee
SAC
I" ;;.~
Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
Builder's Deposit
Other
I TOTAL DUE
This Application Becomes Your Building Permit When Approved
I Paid
I Date
-j(p.oD
.J(.... 111'J- y f
Building Official
Date
# $
# $
$
$
# $
# $
$
$
$ Ib~()J
,
Receipt No. l{b J:;$f
By ~
U
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