HomeMy WebLinkAboutBldg Permit 01-1083
Date Rec'd
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 bULLu,~)
ADDRESS
4/79 CoICJ~(J
Sf-
LEGAL DESCRt!' lION (office use only)
LOT dkBLOCK ~ ADDITION
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OWNER
(Name)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
PERMITNO.t;>/- It) ~3
ZONING (office use)
J2 '5 D
PID;)5-(}Ob'" () lJ,-6 ,
- .... -
(Phone) (Ol~ - 7'1<; - a:f'61
k/uJ~ IJA., R6{j"
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2J.p SO 6) dQJ .sJ... .
(Phone)
(PhOne)$~' 3/</c-J
TYPE OF WORK
-:I(f"1-ti 19 AJ
OPorch
OAddition
~Roofing
CLOSE FILE
10/28/03 MP
I hereby certify that I have lwu.....__ _____ he best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-mentioned property and that all construction 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
enter upon the property to perform needed inspections.
'---1-"'-'1 ' J_... ~ II . ..... "
'r~ 7".1"'~/L-./
Signature
o Misc.
x
Permit Valuation
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
OAlteration
VALUE (exdudingland) $
~tJl,J3/7~
Contractor's License No.
$
$
$
$
$
$
$
$
Park Support Fee
SAC
'-7lf - 7r
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
1/ ;)~
This Application Becomes Your Building Permit When Approved
Paid {~ .V3
Date l,s-.;l-O,
Building Official
Date
ORe-Siding
OUtility Connection
_ID -:J -0.1
Date
# '$
# $
$
$
# $
# $
$
$
$ '7&,00
///1/..,0
I Receipt l::f o. '1 v (p J u
Bv if /
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