HomeMy WebLinkAboutBuilding 03-0949
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
"7 Ie. 0.1
White File I PERMIT NO I
Pink City . o.,7~ oa~
Yellow Applicant '-' /, /
Please
ADDRESS
5/94- /lOPE ~T
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
~
"'~ 0 eIi I
LeJl\.JG..
D.
(Phone)
(Address)
slq
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
ZONING (office use)
/2IS0
030. eJo5. I
952
'{t(? 8S'7()
TYPE OF WORK
Re-Roofing
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 prope 0 perform needed inspections.
~
Signature
o New Construction
o Deck
DPorch
DLower Level Finish
o Fireplace
DAddition
DAlteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
x
Park Support Fee
SAC
#
#
Contractor's License No.
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Water Meter Size 5/8"; I";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Building Official
Date
DUtility Connection
'7-I.g-~V
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 (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372