HomeMy WebLinkAboutBuilding Permit 05-0421
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
~ tl 05
I. White File I PERMIT NO
2 Pink City . 05- 04 Z-'"
3. Yellow Applicant ,
ZONING (office use)
04-
Lf lJ11{S
PCLV'L. N I GO I ti/t-
LEGAL DESCRIPTION (office use only)
LOT Z BLOCK 2- ADDITION P/1'/C4~~ jJlC()/./Lh-r
PID Z5. .3 q I. 003. ()
OWNE~ "
(Name) ~. ,<)~\'VL
ck-
~ t'l\l VY\
(Address)
1
(Name)
(Contact Name)
(Address) 8-k.b
TYPE OF WORK
o New Construction
N
o Deck
P((~I
I aJ.L,
(Phone)
rf- LW
r
(Phone) ILP ~ -6(0 -7 - ~<S2JC)
(Phone) ~
PlL{rYL~tJ~1 VY\~ 0~YYL
o Porch
ORe-Siding
ORe-Roofing
OLower Level Finish
o Fireplace DAddition OAlteration
~ f\ {J::,
PROJECTCOST/VALUE (excluding land) $ ~.
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
autho . ed 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
sub i d 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
ent on the pr e to p rform needed inspections.
'J
.1
x
Permit Valuation
Permit Fee
$
$
$
$
$
$
$
$
600. ()
2~.oo
I .2~
.50
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
our Building Permit When Approved
1o/:.!
CD I~-
5-3-65
Contractor's License No.
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE (l/" ,,;, :L. .- q ()c;- $ 4-/ 75
~. . ~
I ~~cei?~/f3
I Paid
Date
.,. /. 75""'
5__/I.O~
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
'f
Date Special Conditions, if any
24 hour notice for all jnspections (95e) 447-9850, fax (952) 447-4245
PluM- tOJ \ lU l 0-L *