HomeMy WebLinkAboutBldg Permit 02-1123
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please tvDe or print and sign at bottom)
ADDRESS
/! 2.5/ tOf-O,et1DO ~Tf2e,6r
LEGAL DESCRIPTION (office use only)
LOT /4BLOCK /
ADDITION t-11t:6S/LJe; Gfleo6/1is
OWNER /I \ I
(Name) I /h K t- t, ~
.....
tJl' (' 1-. J/!/;1 ~ /I e / ~
/)u/uil\ /Iv
~~~~R NM (l//;/ul-reeV ~
(Contact Name) R ~: d J.J 1:1. ~ I_"'a ..f'+'
If'/S-? A7 ~ t:'- t!/tl A/E
(Address) .JJ. . "I') I- t.~ k 1'. Nt/!/.~ 7.;z __ /..;? ..<.....::t.
. LJ::..J- / _ .
TYPE OF WORK
(Address)
if/31!
,
r--1 .....T____ ""___"--_~__
nn.........1,
OPorch
o Misc.
CLOSE FILE
10/28/03 MP
Ice
OAddition
1ST IV ALUE (excluding land) $
I Permit Valuation
I 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
I. 2-5
Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I. White File
2. Pink City
3. Ye\low Applicant
Date Rec' d
PERMIT NOi1J."" J./~
4- .
ZONING (office use)
)f!./SO
PIDe) 5- ()f)h - OO&'- 0
(Phone) _,9 s,;< tj '17 - :/./1 9 /
(Phone)
(Phone)
93:z
~-I
I hereby certify that I ] ; to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for th~ __ _ _ __. .. _ will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I a ware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
=~tnili'prop OP-=~e.:~~ ,~/rhO()~
- , Slgnatufe Contractor's License No. ~ l>~::::
1/ II
2..,50d .00
$ 1~. 75
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
City SAC and WAC
X'Re-Roofing
o Alteration
#
#
#
#
This Application Becomes Your Building Permit When Approved
I Paid
I Date
'/fp. ..--
q-/I)/?-- By
Building Official
Date
'/~.J~"; ~3' i 7(!{~\
6~::Z-':l[l7.3 ~8j
ORe-Siding
OUtility Connection
$
$
$
$
$
$
$
$
$ 7(,.00
~I .41_ ,
Receipt No. l.iCJ..f a--f
jJL/
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