HomeMy WebLinkAboutBldg Permit 01-0977
(Please type or print and sign at bULLum)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 61./ q11
I. White File I PERMIT NO ()
2. Pink City . -, 1_ 1'21'/
3. Yellow Applicant I 7
/ 4-~34- t;;:s7717& /f-t/ t/ J~
ZONING (office use)
Jet :5D
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
><
OWNER
(Name)
(Address)
J
BUILDER /Ov.ulP/Z--
(Name) ,- L Afr,,,,- I~~/t/ts
(Contact Name) _~ti....e.
(Address) /t? 3<t E STti~S /l-v~ 5 E
TYPE OF WORK
o Misc,
CLOSE FILE
10/28/03 MP
o New Construction
I hereby cer
authorized a...
submitted plans. I am aware Ula. ~._ _
;t:2~: ;torm needed inspections,
(' Signature
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
$
$
$
$
$
$
$
$
L}SOO,O0
'7-1 75
..---
lz5
s Your Building Permit When Approved
9- I-ZeD!
Date
PIDZ5-/S+ - /)05-0
(Phone)
(Phone/9 r; ~ ) ;;..ab -- 'J..?? t;(Ij)
(Phone)(9s-;1Y 15)0 -6S<16 @"
'- /
ODeck
~e.Roofing
ORe-Siding
OPorch
o Fireplace
OAddition
OAlteration
OUtility Connection
'JECT COST IV ALUE (excluding land) $
In which is to the best of my knowledge true and correct, I also certifY that I am the owner or
Istruction will conform to all existing state and local laws and will proceed in accordance with
this permit for just cause, Furthermore, I hereby agree that the city official or a designee may
;- '7- 01
Contractor's License No. Date
I Park Support Fee # $
I SAC # $
I Water Meter Size 5/8"; 1"; $
I Pressure Reducer $
I Sewer/Water Connection Fee # $
I Water Tower Fee # $
I Builder's Deposit $
I Other $
I TOTAL DUE $ "1 (,. () rJ
I ,
I Paid '7/~ ,()O ReceiPt No. '-.{/J..1'46
I Date t:;-"7-1 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 documer
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 I
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245