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HomeMy WebLinkAboutBldg Permit 01-1156 -4 1~,~CJ 8' 1--f.r-C' CITY OF PRIOR LAKE BUILDING PERMIT, 7 r;..t ~ TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT "'C? .C\. ' n.,"= r~[Q) I. White File 2. Pink City 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS j(/ /I ... ~St ()~ I~~se LEGAL DESCRIPTION (office use only) LOT It.( BLOCK ( ADDmON ~ae, fl)lflp OWNE&--'" -::- tJL .. ." /1/7_ .. ~ (Name)~~(~ (AddreSs)~E tis ~ILE ~~~;:~LJ I( l3It,0 Gre;e/:d~s ~(j . ,. . (Contact Name) (Address) TYPE OF WOR' ODeck OPorch o Misc. CLOSE FILE 10/28/03 Mp ,lace OAddition :OST/VALUE (excluding land) $ Date Rec' d "I .~. ."' I PERMIT NO. 0/1" I) 5" ~ ~i--' PID ~5-3"-3S- tJ /Lf-Q (Phon{2?:J) t)cj 7 ~%W2I . ~-ROOfing OAlteration ORe-Siding OUtility Connection I hereby certify that I have lUuu__. h 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 propt:HJ _. on will conform to all existing state and local laws and will proceed in accordance with ial can revoke uu. y.:rmit for just cause. Furthermore, I hereby agree that the city official or a designee may ns. ~&,q /l>/;t>~1 . Contra~or's License No. . . Date (Phon{.~/t~/~a-~ (Phone) &5' ~CN ~E /h .-55".,.~tt x u I Permit Valuation Permit Fee Plan Check Fee I State Surcharge I Penalty I Plumbing Permit Fee Mechanical Permit Fee Sewer & Water Permit Fee I Gas Fireplace Permit Fee I Park Support Fee SAC $ '7'1... 7~ $ $ /rJ..~ $ $ $ $ $ Water Meter Size 5/8"; 1"; Pressure Reducer Sewer/Water Connection Fee I Water Tower Fee Builder's Deposit Other I TOTAL DUE I paid})? (p ,v.S-- , Date /O~ Id.-O f This Application Becomes Your Building Permit When Approved Building Official Date # '$ # $ $ $ # $ # $ $ $ $ 1ft, ,OJ Receipt No. t1 U If 06 By ft0 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