HomeMy WebLinkAboutBldg Permit 01-1088
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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1. White File
2. Pink City
3. Yellow Applicant
PERMIT NO_!, 0 ~fJ
/.ONING(O_=J
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ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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(Address) 9!5c<!/ :)7{J...J6/K 45 ~'
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(Contact Name) ~~~
(Address) /9~GJ6 (~ r:~
(Phone)
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(Phone) 4;t;2....,..2~ I"~..f&t.tj
(Phone)
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~;~/~ $?J ,-\"~5"76Z
o Fireplace
o Porch
OAddition
IDe-Roofing
ORe-Siding
TYPE OF .
ODeck
o Misc,
CLOSE FILE
10/28/03 MP
OAlteration
OUtility Connection
JECT COST /V ALUE (excluding land) $
I which is to the best of my knowledge true and correct, I also certify that I am the owner or
t all construction will conform to all existing state and local laws and will proceed in accordance with
revoke this permit for just cause, Furthermore, I hereby agree that the city official or a designee may
Building Official
:2 00f R o..~'1' /~
Contractor's License No,
Z-,,!> tJ tJ I (f1) Park Support Fee # I $
$ 7c.f.7r SAC # $
$ I Water Meter Size 5/8"; 1"; $
$ /. z..- r I Pressure Reducer $
$ Sewer/Water Connection Fee # $
$ Water Tower Fee # $
$ I Builder's Deposit $
$ I Other $
$ I TOTAL DUE $ 7' ,o-i)
- ,/J .
en Approved I Paid ~~.(/U ~;fJI1o. /fOr, 72-
W-l--,t I Date .III. ~ ~,.o .
I
Date
Permit Valuation
Permit Fee
I Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
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