HomeMy WebLinkAboutBldg Permit 01-0888
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3 . Yellow Applicant
(Please type or print and sign. at bottom)
ADDRESS
6"3,\0
& kG i'V\
~w
5/-.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
jY)~J' JL Hetla~
'"
3S 1 () ~ k.Q../l-'\. st
(Phone)
(Address)
Sw
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cr
BUILDER
(Name)
~hru\.2.
(Phone) (Ol(}.- 38'-1- u359
(Phone)
(Contact Name)
(Address) /6;7/{.R /l7o...f'4Sf~ 17ol.
(J
SJ.o..k.o~~ , f'l1-J
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TYPE OF WORK
81te-Roofing
OAlteration
- ")fch
o Misc.
0--
c: CLOSE FILE
10128/03 MP
.ddition
:exc1udingland) $ 3%00 :~..
I hereby certify that I have furnished my knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-menti"..__ y'-Y_UJ ~._ u.u.~. _v...uu__v.. n~ _v~vu.. (0 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
enter upon the property t e 0 needed inspections.
~d~
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Contractor's License No.
I Permit Valuation
I 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
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Z, >of)_rv
$ . 7t/, 1 r
$
$ t. Z/
$
$
$
$
$
nmAPPEiii!J-~ YO~BuilWngPf_;_~
Building Official Date
I Paid
I Date
7(,- uV
y- J(j -tJ .I
Date Rec' d
'~ONING (office use)
I /24
PID
4Ll6- (0 8S'S:
ORe-Siding
OUtiIity Connection
8- ck; ~
~e J
t /
# $
# $
$
$
# $
# $
$
$
$ 71R. v-z.)
./ /7
va ~~l'
B~ '
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