HomeMy WebLinkAboutBldg Permit 02-0954
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Vellow Applicant
w_~morimmdL-~ 111/('-
I ADDRESS
I fS;) .. & rtk
LEGAL DESCRIPTION (office use only)
LO BLOCK ADDITION P cuA- PID
OWNER 1~;l-'1f7- Oa03
(Name) (Phone)
(Address)
(t'). (Phone) QS2-,ffS-99(}t(
(Phone) 9SZ-212-Qh70
TYPE OF WORK
o Deck
OPorch
OAddition
ORe-Roofing
o New Construction
OLower Level Finish
o Fireplace
Iteration
PROJECT COST IV ft T .-
~-Siding
OUtility Connection
PO
'correct. I also certifY that I am the owner or
':allaws and will proceed in accordance with
_ agree that the city official or a designee may
I hereby certify that I have furnished information on this applic3~~
authorized agent for the above-mentioned property and tha' "{:\..~
submitted plans. I am aware that the building official can 1 ~~ ~ ~
enter upon the to rform din 'ons. C\.Ov ~y
X \ OI~~IO'
-', /-r3/2
~ontractor's License No.
8).02
Date
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $ ,~
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
WaterMeter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Date
Building Official
$
$
$
$
$
$
$
$
$
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