HomeMy WebLinkAboutBldg Permit 02-0255
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
3 - 2,0 -0 '2..-
I. White File I PERMIT NO
2. Pink City .0 z....- ,.- tJ l- n
3. Yellow Applicant
(Please type or print and si2ll at bottom)
ADDRESS
5376 ,q, / e--c..-rJ tAl IV s#rJ /Z6.5
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
. (Phone)
BUILDER --V -r; r.
(Name) M~J-!Jb'K~)&.j ; , AII_.
(Contact Name) . IIr- RfiTT"P:
(Address) 'fJ-c- AllIldvl~~P [,J.e U~5. ~
(
TYPE OF WORK
o Misc.
CLOSE FILE
10/28/03 MP
I hereby certify t\
authorized agent
submitted plans. I am aw
enter upon the property to
x
I Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
n "T_.. r"__ "
z,J ~ CI O. 0 0
$ , 7c./. 1 r-
$
$ I. 'Z--J
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
~
Building Official
') ~ ?, 0 - fI "L.,...-
Date
(Phone)
(Phone)
S-flJ/</
fVJJ./,
'Jeck
OPorch
OAddition
/
~-RoOfing
OAlteration
ZONING (office use)
~f 5' J:)
PID z.s -/fR1- ()t) / ~()
6)7. !t:U.~
#
#
#
#
ORe-Siding
OUtility Connection
$
$
$
$
$
$
$
$
1$/~..dc)
I ReceiP.tW) 4-/~/ Y
I By /JIJC-
I
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.
rich is to the best of my knowledge true and correct. I also certify that I am the owner or
. & ._~~ _ ...go.... .._...._..ction will conform to all existing state and local laws and will t'&..",,,,,,,d in accordance with
a e building offi can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
needed inspections. 3/2P / ,,"2-
ignature . Contractor's License No. . Dale
Planning Director
Fireplace
:T COST /V ALUE (excluding land) $
I Park Support Fee
SAC
WaterMeter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
I TOTAL DUE
I Paid
I Date
7(p.6 0
7 - V, o'Z..--
Date Special Conditions, if any
24 hour notice Cor all inspections (952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372