HomeMy WebLinkAboutBldg Permit 02-0399
CITY OF PRIOR LAKE BUILDING PERMIT, ~e Rec'd
ORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si2ll at bv..u~)
AD~64S ()~
LEGAL DESCRu'uON (office use only)
LOT
BLOCK
ADDITION
I. White File
2. Pink City
3. Vellow Applicant
tALk
~
L _ ./"'l
OWNER /If A \ C\.//A ./JPA _ (/
(Name) ~ ~_
._~ t:LotV~
- ,..
=)ER ~ .dM,.
(Contact Name) fJ1If;R.U -
(Address) 1ft6 V~~?lue S~
U I
(Address)
TYPE OF W----
o Misc.
CLOSE FILE
10/28/03 MP
PERMIT NO.OZ..o> '.?
ZONING (office use)
PID
(phone) '(J;;,~-m1
'Deck
DPorch
I hereby certify fhich is to the best of my knowledge true and wu..~~. I also certify that I am the owner or
authorized agent .v. wc aVVVC-lllCllUUnCU y."y~..y anu Win an constrUCtion will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware that the ~ding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;terupon"/!.Z.:1"'7~ ~ yI~~
I-f{ ~ / ) sr~e Contractor's License No. Date
--
(Phone(9~___)~1 ~d$d-
(Phon
( 5"'7~j
",'" ""lIg ~-Siding
Fireplace DAddition DAlteration OUtility Connection
crCOSTIVALUE (excluding land) S ....:J';rt:5>~
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
'2 ..~.CO
. 74. 1c;
J . 25"
$
$
$
$
$
$
$
I ~Gas;eplace permiAee $
is p . atn *es Your Building Permit When Approved
~ ~-O?
uil . g Official Date
Sewer & Water Permit Fee
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date 4'. ""1. "'O""l.....-
# '$
# $
$
$
# $
# $
$
$
$ 7(, . ()IJ
ReceiotNo. ~i;2-
By lIB- .
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may Y' ~~~~j 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