HomeMy WebLinkAboutBldg Permit 01-1426
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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I. White File
2, Pink City
3, Yenow Applicant
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(Please type or print and sign at bottom)
I ADDRESS .55S'O
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT +-aLOCK / ADDITION
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PID '-b - '3 () '2- - O?J 4-.... 0
I OWNER
(Name)
(Address)
(Phone)
BUILDER Ai
(Name) S~/O-r- /JAfl)F/ tJ
(Contact Name)
(Address)
(Phone) 88~ - 1'6 fJ'f
(Phone)
ORe-Roofing
OAlteration
ORe-Siding
OUtility Connection
TYPE OF WORK
CLOSE FILE
10/28/03 MP
)porch
]Addition
o Misc.
E (excluding land) $
-,
I hereby certify that I have furnished information on this application which 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 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 the property to 70~d i1lspections. ~ J~ I;) 0
X \ 4/"- R' t- /) ~ 01
1<.. I Signature Contractor's License No. Y ljate
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Permit Valuation ~ Z,SO 0.00 Park Support Fee # $
Permit Fee $ 7<1.7, SAC # $
Plan Check Fee $ ~ Water Meter Size 5/8"; I"; $
State Surcharge $ I .1-\ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ "-1t. .00
I Paid
Date
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This Application Becomes Your Building Permit When Approved
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Building Official Date
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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
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