HomeMy WebLinkAboutBuilding Permit 02-1103
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Date Rec'd
CITY OF PRIOR LAKE
I, ~ ~L U fll ,,,, ATJiK P,KJ:( MIT
. 'i~; ~ ..[~L~
'5 l;V , -.-.
I. Green File I PERMIT NO
2 Yellow City '0"'- j / Il~
3. Gold Applicant. '-'- / ILL?
3~5tt MAJB5Tl ~ L-ANE
LEGAL DESCRIPTION (office use only)
LOTL BLOCK 4 ADDITION
8-z9~02-
NvV
ZONING (office use)
PID
OWNER II
(Name) -.-JVF vV'S..t1 ANN No AI\, ES
(Address) /895 Ph12A (J!!-, /12ZC
(Address)
(Phone) (;L:, \- L\OG - 440()
CAe," I"rVV ,.;1I'J S<,iZ Z
(City) (Zip Code)
APPLICANT /2.
(Name) y,1AJ
(O/lJ-r/l,4{(/VV[- (u.
f"5 tit Auc- ~
(Address)
952- 8'1tJ~ <; zoo
(Phone)
ok:, lu .;l.<-( ~1Aj
(City)
(Phone)
DATE
(Address)
'! 700
(Contact Person)
~537 "
(Zip Code)
95/ - 8'iLj- 5Z 0 U
B- zt? -GZ-
APPLICANT PLEASE COMPLETE BELOW
Size of water service /. ~~ inches.
Location of any couplings from structure _ feet.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet. /' \
Clean out (if required) located at _ feet from structure. C r /-!,;; /(,.;+ TrP, v 56;2.// i (~ )
"
Residential sewer and water line connection
. Sewer connection only
FEE SCHEDULE
$35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39.50 minimum
$17.50 Water connection only $17.50
Estimated Cost $ /, () (,1 0
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
1:~~iQ=~ ,..n.. -, ~'/:7~ ;e.....
----- ~;1;2 ~1T'j "''''6.''' <%(<. I Dot"
$ ..3". 50
$ .50
$ 1-/0. <'0
Paid +CJ. 0 {)
Date
..lJf . C) z-.-
Receipt Np/>"V(.J 1
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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