HomeMy WebLinkAboutBldg Permit 01-1092
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sil!;ll at bottom)
ADDRESS
3CjQ3
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO'Of -11)l?~
N'(~ Prrnd~
LEGAL DESCRIPTION (office use only)
LOT Lf BLOCK -3 ADDmON'~AJ1131 ~ /
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(Address)
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PID :;20 ;2(<j- {)J."3-C/
(Phone)
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(Contact Name) ~kue. .kL:J_~~A.JtJ
(Address) Cj 00/ 1?, ~ 7? cl
TYPE OF we
CLOSE FILE
10/28/03 MP
o Misc.
(Phone)
(Phone)
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'ck
OPorch
ORe-Roofing
JaR-e-Siding
OUtility Connection
1 hereby certify thal _ __......~... uUUHnauon 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 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 cial can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
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'--"'" Signature Contractor's License No. Date
Pennit Valuation
Pennit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Pennit Fee
I Mechanical Pennit Fee
Sewer & Water Pennit Fee
Gas Fireplace Pennit Fee
replace
OAddition
OAlteration
COST IV ALUE (excluding land) $
$
$
$
$
$
$
$
$
7l/- 75'"
Park Support Fee
SAC
#
#
I Water Meter Size 5/8"; I";
I Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
/,,~s-
#
#
This Application Becomes Your Building Permit When Approved
Paid
Date
7{p,.UU
/ (J- .+-O'-(
Building Official
Date
, $
$
$
$
$
$
$
$
$
'"
7fo ,eX)
Receipt No. Li ex;, q S--
Bvgu
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