HomeMy WebLinkAboutBldg Permit 01-0980
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
?-7-01
(Please type or print and sign at bottom)
ADDRESS
I. White File
2. Pink City
3 . Yellow Applicant
Date Rec' d
I PERMIT NO. 01- Of/~o I
.
5690 ~05S/tN0,e4
~I
56
LEGAL DESCRIPTION (office use only)
LOT /3 BLOCK / ADDITION eARLJIAlAL- RiDGe; /s:,. A-O()AI.
OWNER
(Name)
RAND"
I
SANe
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
5(!"HI1F&e
TYPE OF WOR} CLOSE FILE
10/28/03 MP
o Misc.
ZONING (office use)
PUD
PID25-Z'l'l-O/3-0
(Phone) 4'~O - 2. e~z-
~/2- 7(,O-7~
(Phone)
(Phone)
ace
o Porch
OAddition
)8[Re-ROOfing
OAlteration
ORe-Siding
OUtility Connection
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-mentioned t'~..j and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware uilding 0 . ean revoke this t for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the prope needed' ections.
x
---~ -
S. ...-~
1" ,.. ,,- . '7""
,
/"
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
2,500.00
$ 7t./. 7S
$
$ /. zS
$
$
$
$
$
Date
)STIVALUE (excluding land) $
Contractor's License No.
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
'7/"". 0 0
'9-7-01
#
#
#
#
7l- 11- - eJ/
Date
$
$
$
$
$
$
$
$
$ 7b.OO
R.ec~
By /_.. "
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