HomeMy WebLinkAboutBldg Permit 02-0489
(Please type or print and siJtll at b~ ..~~)
ADDRESS
39 3':<
lnJ~~~ Ci
(Name) 1I:55/r--
( .~nle)
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3 . Yellow Applicant
II~ p~ 01/1/
o ;).-l/~<1
PERMIT NOi1,J - OL/~I
ZONING (office use)
RI
PID~ "d-5Y..... OOL/-D
;;ond TL-
(Ylm h... QS-2- 4l/ 7 - 310 b'-!
~-
'j(] ur
/2ot)/) /2-I'/I/~ S gkM5,tll/Lt /!IV.5.5 337
LEGAL DESCRIPTION (office use only)
LOT I BLOCK 0 ADDIDON flMf~ /ldtji I[;j-
= ",t Ibm f2-4-rt-h ~
(Address) 3 q 3 2 tlz.ddt1J
I20tJ 15 <:[::JlL-;
TYPE OF wr~TP
Jeck
OPorch
OAddition
~-Roofing
OAlteration
Fireplace
o Misc.
CLOSE FILE
10/28/03 MP
:T COST IV ALUE (excluding land) S
I hereby certify d .rich is to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent, ..... AlJVY"'"llICIluonea property and that all construction will conform to all existing state and local laws and will proceed in accordance with
~='Pbm; a a "fl;!:f=rero~~_frx~;~;;:;;;;~;Z~~70~i~-Y
. ,Contrlltinr'. T ;~.A No. ~~_
Q5"o-J c-CfJ I Park Support Fee # $
-ztA- l S- SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
# $
# $
$
$
$ r; h,CO
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
l;~S-
I Sewer/Water Connection Fee
I Water Tower Fee
Builder's Deposit
Other
I TOTAL DUE
\
J QS2- 81 r f 2,/ Ii
ORe-Siding
OUtility Connection
. Receipt No. 1.1 ;),PCl~
By ~ r'~
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
Your Building Permit When Approved
I Paid
I Date
1(~.tJO
~-I, /?i3...
Date
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
(