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HomeMy WebLinkAboutBuildign Permit 02-1205 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec' d fI- 20 ~CJ2- 1. White 2. Pink 3. Yellow File City Applicant PERMITNO~~_/ZO~ ZONING (office use) bG LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (N ame) (Phone) (Address) BUILDER It , (Name) '~"'~ r1 ~S (Phone) (Contact Name) ---M,V.e V ~l~L (Phone) ~ - (Address) r~'TS ~ltt.t<( ~{l\~~ Ju. \-~C 2eo I ELL "at4 ; MAJ SS'I2. 7. o New Construction ODeck o Porch ORe-Roofing OLower Level Finish o Fireplace OAddition Ob- 441~ 4Ob= 44-/() ORe-Siding OUtility Connection I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. ~ war.e t e building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter u the p e . 0 ern m d inspections. X ' "-1'1-02 Permit Valuation / Permit Fee $ Plan Check Fee $ State Surcharge $ Penalty $ Plumbing Permit Fee $ Mechanical Permit Fee $ Sewer & Water Permit Fee $ Gas Fireplace Permit Fee $ LB7- PROJECT COST IV ALUE (excluding land) $ Contractor's License No. Park Support Fee SAC # # Water Meter Size 5/8"; I"; Pressure Reducer City SAC and WAC Water Tower Fee Builder's Deposit Other # # Date $ $ $ $ $ $ $ $ $ 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 Zonmg compliance and allows construction to commence Before occuyaeq, a,~rt1!iiate of Occupancy must be Issued.. ;A~ rN.A.b-t .tK, b ~..V'TU'\ . qjz-'1 JbL ~U 1T \fN. ~J~Lht.. ~ , Date Special Conditions, if any 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue Prior Lake, MN 55372