HomeMy WebLinkAboutBldg Permit 01-1227
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3 . Yellow Applicant
PERMIT NO.O/_ J d-J- 'I
(Please type or orint and siltll at bu.",~)
ADDRESS .a /J.. . /J .,. _ I
jL/t,l/1J ~ct
ZONING (ofliceuse)
RlsD
LEGAL DESCRIPTION (office use only)
LaTa BLOCK Lf ADDITION KiutJ h
IJd
PIDc:95-3/0 -()3~
OWNER
(Name)
(Phone)
(Address)
I .fA I) . Y) ~JL/1 rLoof; 11 \
(Contact Name) -r~cf) U J-t~,~
~~. 6S- D-1J 1\1 liJ r/0 ~
BUILDER
(Name)
(phone)
(Phone):Jj. '3 - c{zD - ZS-C,!
(Address)
TYPE OF WORK
CLOSE FILE
10/28/03 MP
OPorch
OAddition
)iilfie-Roofing
OAlteration
ORe-Siding
OUtility Connection
o Misc.
,UE (excluding land) S
I hereby certify that I have furnished information on thiS app.....u~_._ Jest of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the ab tioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. ". ~'~ = w ",... ~.:~g Offi.. .;.I = ~"'" thi mri. ." jwt am,. Furtb<==.' h=by ...." \bat "" cily om.. cial. or atSignee may
=teruP~ld'ZKa. erform Aspe7ons. ;HJ 1 3.2 1~9 J(j/?-? d/
~irture ~ . j "-f,I.iooD<No. , "'"
I Permit Valuation \f)' 0) 01 uu . I Park Support Fee # $
I Permit Fee (\~{ <.~ $ . 't{..... I ~ I SAC # $
!PlanCheckFee \j $ -7l/,,7S !WaterMeter Size 5/8"; 1"; $
I State Surcharge $ J" J~ I Pressure Reducer $
I Penalty $ I Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ I Other $
I Gas Fireplace Permit Fee $ I TOTAL DUE $ 1 S- 0 I I.~
This Application Becomes Your Building Permit When Approved
../
I Paid .ff(50J '75
I Date 0- -::JC]-t).'
Receiet No. LlO /f (P >r
BY~
Building Official
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