HomeMy WebLinkAboutBldg Permit 01-1310
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/1-/5'0 I
\ Y\ .::\
7 ad;- ~
A
OWNER /"l I r,J L r-
(Name) -L ..; A (' j . ~. DCe. e..(.....Y\..eJ
(Address) / If 170 r; (' y>. ':1 \ \ V\ ~ C "
'-,
BUILDER / I J c '
(Name) Vl V\ \ t -e.. ov\.S~'('uCTIOI/\ . If1 C.
(Contact Name) k:~ Q.\ r.\. VV\ ~ V\ v\ "I Vl (l
/r~ ~ Ll4k.e Dr,~ wasT
CLOSE FILE
I hereby certify tha 10/28/03 MP ~h is to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent fo .on will conform to all existing state and local laws and will proceed in accordance with
SUb~m' . s, I .. t-.;:~' U'~'(''lal can rev]tke 's permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter po e property to p~orm ede mspecnons...... -:It /' ) I
X _ .PLl VlA.,R, . c.vt~..{ :&- ~0J1.00 71 , / -/~-o
Signatur Contractor's License No. Date
I
VI
1$
$
$
$
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(Please type or print and si~ at bottom)
ADDRESS
/L//70
G (' "'---~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Address)
TYPE OF WORK
o New Construction
nneck
o Misc.
I Permit Valuation
Permit Fee
2-,.>OO..vo
7 c.f. 7>
Plan Check Fee
State Surcharge
(.1.-.r-
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
1l.jJ./JJ--- 11-,) -- 0 I
Building Official
Date
C'f.
)Jf,
L White File I PERMIT NO.
2. Pink City
3. Yellow Applicant
-131D
PID 25-930- O?tf- 0
(Phone)
9Q- 4'03 - oS-Cd)
AI t..
(Phone) 9'.~ -- 5ld ;?- C; 1/ q ~
(Phone) 0; t; ;).. - "!:>(nY' - '7 q 4" f:?
ChCLvthAS5eLA f1.11A S-).~/?
~e-ROOfing ORe-Siding
OAIteration OUtility Connection
, COST IV ALUE (excluding land) $ 905-;). C; ~
OPorch
replace
OAddition
I Park Support Fee
SAC
I $
$
$
$
$
$
$
$
$ 7& .dO
#
#
Water Meter
Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
Paid
Date
') V - () cJ
,1.1-4 _r, 4
Recei~2, (,
By ,__
. 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