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HomeMy WebLinkAboutBldg Permit 01-1029 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 9-18'0/ (Please tvI>e or Print and sign at bottom) ADDRESS Date Rec' d I. White File I PERMIT NO 2. Pink City '/_/ 3. Ye!low Applicant 58/7 ffl1::.O / /II rr C-- et 066 . I ;::A/V LEGAL DESCRIPTION (office use only) LOT 3 BLOCK 2. ADDITION ~//lf~ I2IO(i6 Isr I hereby certifY that I 1 to the best of my knowledge true and correct. I also certifY that I am the owner or authorized agent for the above-mennoneo pm!,,,,,y am.. .,Uu. ~ w.._____.__ 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 ;terz;;;~:;;orm needed inspections. ~ ~ , OWNER (Name) (Address) (Name)ElpdJ jJO..lA.JL (Contact Name) fJtJ..I..I.JlJJ Ptr6-f; (\4 Z~a5 Lu ~~~. ~+ s) l5f iff ?LA: .'Jt:. I ,"-17,A) ~(;.p11 TYPE OF WORK CLOSE FILE o Misc. 10/28/03 MP I Permit Valuation I Permit Fee Plan Check Fee 2.,500,0-0 $ . ,1./. 7~ $ . $ $ $ $ I $ I $ State Surcharge I Penalty I Plumbing Permit Fee I Mechanical Permit Fee I Sewer & Water Permit Fee I Gas Fireplace Permit Fee - I. 2-.., This Application Becomes Your Building Permit When Approved yJ ~ q-lfJ-O J BJil~cial Date (Phone) (Phone) (Phone) o Porch 1!fe-ROOfing OAlteration PID z5-ztJ9 -/12-3:0 'f 9:; - t' 7~/ ORe-Siding OUtility Connection # ~iZ~ $ $ $ $ $ $ $ $ $ 1(,. oz) ce OAddition # # # R~C~ 4t;JS'1' / 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 ST/VALUE (exc1udingland) $ 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 I Water Tower Fee I Builder's Deposit lather I TOTALDUE I Paid I Date 'if/) . ()V a- / r/ ~/J I I ' J , Date Special Conditions, if any 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245