HomeMy WebLinkAboutBuilding 06-0028
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/.1. {;t;:.
~. ~i~~e ~~:y I PERMIT NO. 0/- - 06Z81
3. Yellow Applicant . "e'.
ADDRESS ZONING (office use)
I~
c
(2/ .:5D
LEGAL DESCRIPTION (office use only)
LOT 5 BLOCK Z ADDITION /VI/) IZiI 1"Jr} KGI'4~L6'r 1ST /lOOIJ
PID25.24-4-. 00 A. 0
OWNER
(Name)
!1ECyHf2P...-<.f. ..01 f2...{c .
I
t3' tJ/JrJl6
(Phone)
(Address)
BUILDER
(Name)
KII.
W /T"1"" () "tV .5~ tt.~ 77 0'''-
(Phone)
(Phone)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
o Deck
o Porch
ORe-Roofing
ORe-Siding
OLower Level Finish
o Fireplace
o Addition
OAlteration
OUtility Connection
PROJECT COST IV ALUE (excluding land) $
'1 S- c::< S-. Q:]
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. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to perform n~d inso~.
X )V/I I/'
f Sign~ Qfre Contractor's License No. Date
/
Permit Valuation 'J Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; I"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ ltc, () 0
This Application Becomes Your Building Permit When Approved
5{J
Building Official
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 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