HomeMy WebLinkAboutBldg Permit 02-1057
(Please type or print and si2ll at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
8.,z7
I. White File PERMIT NO
2. Pink City 'YIZ - IDS 7
3. Yellow Applicant U
--
S44-Cl d.ef7.Jj:::.J U I!:-U b S {:;
LEGAL DESCRIPTION (office use only)
LOT SBLOCK Z- ADDITION p~J::;./'l/t~ ~
OWNER
(Name)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
LJ,fS,S I G ILc 0 r.s. :rA.J
Phtll.l7 VAI.1€-?
,
ll.-oO() /2-- At/I:: S
TYPE OF WORK
CLOSE FILE
10/28/03 MP
o Misc.
(Phone)
,
ZONING (office use)
)!!:../
PID 26 - oz-I -VI/V
(Phone)
(Phone)
9S-2- ffS 9 ~/8
~/2.. "V..s-o'j3o
/'t1N ..s.s 337
tS4~S I/III~
OPorch
"
~e-ROOfing
OAlteration
ORe-Siding
OUtility Connection
I hereby certify that I have .he 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
SUbmitte1fjflPI . 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
;ter u e pro fl:J:1;.ded inspections. K /'-7/0 2-
si;:-Le Contractor's License No. Date
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
2, .s-VV - q-u
$ ,c.I.1J"
$ ---
$ I, t/J
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
V JvfJJ------ ~.~ 1. c)7.-'
Building Official
Date
OAddition
VALUE (excluding land) $
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid 'l~. C/V
I Date . lJ- Z 7, d-z......
# $
# $
$
$
# $
# $
$
$
~/.6.()D
~ -
. Receipt . q-z. 7 tB I
By .......-;
f/
This is to certify that the request in the above application and a.woooyanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a te...y_.<oI)' 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