HomeMy WebLinkAboutBldg Permit 01-1270
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/1-7'0/
~+.
I. White File
2. Pink City
3 . Yellow Applicant
I PERMIT NO.O / -/2.- 7 0 I
ZONING (olficeuse)
LEGAL DESCRIPTION (office use only)
LoIO BLOCK 1 ADDITION
OWNER
(Name)
(Address)
BUILDER /'
(Name) f.::1. T.. -Sl d t~~ +^c..
(Contact Name) 6 re~ -ri Nl1'\ €-
(Address)
PID z5- '(f-6' 0...0
(Phone)
(Phone) ~ I). -41+ ~4c..j 7
(Phone)
TYPE OF WORK
....... _.0......-.-.:.......
ORe-Siding
o Misc.
CLOSE FILE
10/28/03 MP
nDeck
OPorch
ORe-Roofing
OAlteration
OAddition
OUtiIity Connection
r/VALUE (exc1udingland) $
I hereby certify that I ha 0 the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the aLIVn.-u.~u~~..__ ru. . ill 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 perform ne d inspections.
x
Permit Valuation ;J / ~tn> ~ fI7)
Permit Fee $ 1'f.1s.-
Plan Check Fee $ -
State Surcharge $ I . 2.--S-
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
uiIding Permit When Approved
~
Date
Building Official
Contractor's License No.
1/- '1-0/
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7~.o()
I Paid
Date
~t~ ~
(-7- I
I ~~793
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
16200 Eagle Creek Avenue Prior Lake, MN 55372