HomeMy WebLinkAboutBldg Permit 01-0923
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White File I PERMIT NO
2. Pink City Y')f
3. Yellow Applicant Co'
(Please type or print and si~ at bottom)
ADDRESS "I
5~3- (2C&yd;/U~/ tf(( dLX-:] ~
()
LEGAL DESCRIPTION (office use only)
LOT ??BLOCK ~ ADDITION ~~d 15/~ /5-7
()
lCefJ-r
PIDc2~-~91- OJ-3- 0
OWNER n .
(Name) / -< ~ f'J
I
(Phone) 7S-;)- LtLfO- /S-S-5"-
(Address)
BUILDER
(Name) Sa,me
(Contact Name)
(Address)
(Phone)
(Phone)
(
/~
'---.
TYPE OF WORK
o New Construction
At>>
o Porch
ORe-Roofing
pe-Siding
OUtility Connection
OLower Level Finish
o Mise, Bfl\"lc.. f~ f tI,~
o Fireplace
OAddition
OAlteration
I hereby certifY that I have furnished information on thi~
authorized agent for the above-mentioned property and
sUbmitt~ePla , I am awar that the building official c
enter upon opertyV'rfo~eeded inspections,
X . ~
Signature
CLOSE FILE
10/28/03 MP
and correct, I also certifY that I am the owner or
nd local laws and will proceed in accordance with
~reby agree that the city official or a designee may
fj'- .)d' 0 /
Contractor's License No,
Date
I Permit Valuation ~.O(J I Park Support Fee # $
I Permit Fee "14 .z,~ $ 1t1 I SAC # $
I Plan Check Fee $ Water Meter Size 5/8"; I"; $
I State Surcharge ( . ""to!) $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ I Builder's Deposit $
$ lather $
$ I TOTAL DUE $ ...,~.-
rmit When Approved I Paid '-1L., OV Receipt No. LID '~),1Lf
.;d-dJl I Date ~<?I;;nJO I By ~
{/vO ~t.-t \ I
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
iss~Ac- I' ~ }-u ~~6- ;{
Planning Director . Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245