HomeMy WebLinkAboutBldg Permit 01-1139
LEGAL DESCRIPTION (office use only)
LOT/3BLOCK 3 ADDITION (~~lct..f A/~d~
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ADDRESS
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OWNER
(Name)
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(Address)
BUILDER
(Name)
(Contact Name) _
(Address) It-/I
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White File
2. Pink City
3. Yellow Applicant
PERMIT NO.CJ/_ 1/3 CJ I
J
r:JI!oS.S M.M2A-
ZONING (office use)
PuD
Sr.
PID ~S-~O;l- 03Cl-(.
. (Phone)
t/t/o - "'..I 7j,
(Phone)
(Phone)
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TYPE OF WORK
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OPorch
~Re-Roofing
ORe-Siding
:e
OAddition
OAlteration
OUtility Connection
. o Misc.
CLOSE FILE
10/28/03 MP
T/VALUE (excluding land) $
I hereby certify that I ha _ ._ .....~u.. co the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the (.. . . _ <u~uuuUl:U 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 p""ivuu ~ections.
X Jl.r:~ ~/I~/t/p:J- /d//O/d/
~ature Contractor's License No. Date
This Application Becomes Your Building Permit When Approved
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
Building Official
$
$
$
/q.. 7S-
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ 1ft, ,()()
. - I
tjOft?~fo
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
/,.;).5
#
#
I $
$
$
$
$
I TOTAL DUE
I paid) 7 to ' au
I Date If) - I/}- /
Receipt No.
. By [Y~-'
Date
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
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