HomeMy WebLinkAboutBldg Permit 01-1186
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
/O.ZZ--lJ I
~. ~i:~e ~:~ I PERMIT NO. 0/-// a. / _
3. Yellow Applicant 1/ LP
(Please type or DIint and sign at bottom)
ADDRESS
5'195 F~/Ul7WtJ S/IOIl&S
LEGAL DESCRIPTION (office use only)
'I /
LOT ~LOCK I ADDITION .$~
OWNER
(Name)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
K..JZE;V.s6 R-
JOlWrnJ
TYPE OF WO
CLOSE FILE
10/28/03 MP
o Misc.
/~;----
(Phone)
(Phone)
(Phone)
ck
o Porch
/
~e-ROOfing
OAlteration
ZONING (office use)
PIDr-} S ~ J-' X - () J-{)- 0
l.../ 9 2-~.f r4-2-
ORe-Siding
OUtility Connection
I hereby certify that 1 mlVC lUUllsneu mrormanon on mts application which is to the best of my knowledge true and cuu':'~.. 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 e property to perform nee inspections.
x
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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
2S-tJ?). ([U I
$ 7 --/, '7S- I
$ I
$ / . 7./5 I
$ I
$ I
$ I
$
$
TMA~_P;:~
Building Official Date
'eplace
OAddition
Ci/~/
ate
--
~
# $
# $
$
$
# $
# $
$
$
$/(// .00
Ill)
Rere1' " tJ7:3 (,
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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
COST IV ALUE (excluding land) $
Contractor's License No.
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
7&.ClU
,i 0 . 'L- 1.-- b (
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245