HomeMy WebLinkAboutBldg Permit 02-0938
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
8 -/""02-
~. ~i~~e ~:~ I PERMIT NO. 0" ,."9..,.,,0 I
3. Yellow Applicant V V ~u
(Please type or print and si2l1 at bottom)
ADDRESS
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po/tJ,
~I ~u....B
LOT
BLOCK
LEGAL DESCRJ..t' nON (office use only)
ADDITION
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PIDZS'- 0'0" ~9'O
OWNER
(Name)
(Address)
(Phone)
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BUILDER , I
(Name) ?!3 <:;
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(Contact Name)
(Address) 4LJo
TYPE OF WORK
. 0 Misc.
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
ZONING (office use)
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(Phone) (;,/ Z 7~ ~ 4ft> 7~
(Phone)
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nDeck
OPorch
DAddition
DAlteration
I hereby certify that I have furmsneu u~___ )est of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-mentioned property anD u,~. _ fonn to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware that the building o' 0 e this pA::mm ,~_ , . ause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to p~ "....~~ons = ;' / '
X ~ -= --=.. ~ Z03/~7~"'"\ g~'Z-
~~ ~ ~ ~ Contractor's License No.
I Permit Valuation 2. ~ (J V; 0 0 I Park Support Fee
I Permit Fee $ 7'-1. 7.r I SAC
I Plan Check Fee $ ___ ~ I WaterMeter Size 5/8"; I";
State Surcharge $ ~ . ,- I Pressure Reducer
/. vJ
$ I City SAC and WAC
$ I WaterTowerFee
$ I Builder's Deposit
$ I Other
$ I TOTAL DUE
ORe-Roofing
CLOSE FILE
10/28/03 Mp
,UE (excluding land) $
#
#
#
#
I Paid
I Date
7~.OU
.! -!, ca..-
This Application Becomes Your Building Permit When Approved
BWI~ 6-!,: OZ-
)(Re-Siding
OUtility Connection
Date
$
$
$
$
$
$
$
$
$ ~~. 0 0
I
R.eceiP~' dZSf! ~
By /Jp::;"
-~
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 '~...yu.ary 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 (or all inspections (952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372