HomeMy WebLinkAboutBldg Permit 01-1373
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White File
2. Pink City
3. Yellow Applicant
I PERMIT NO. 01-.1373-
(please type or print and siJtll at bottom)
ADDRESS
~~8 '7 / ro ~r
5E.
;/
'rG(-~l
LEGAL DESCRIPTION (office use only)
LOT ':;BLOCK ( ADDITION 04~ i4IJ<oG
I
c,-
PID 25"-0' f) ~O
I OWNER
(Name)
(Address)
JEAJ~6tJ
)~ {(7 I r-eJ
(Phone)
<;7'
~. t .
~~;~~R '0'OHI\1 H1lU'1 #1 /UJOF C{)..
(Contact Name) 7:fO 1-1 AJ H I} t1 H IJ IV IJ
(Address) 7bO() tv. J- 74'- <;, #)0]
(Phone)
(Phone)
QrZ-92J- -tl r~
6/2-Gfr -!7JOCj
S"jl{Z6
5'.L. P.
TYPE OF WORK
o New Construt
CLOSE FILE
OLower Level F 10/28/03 MP
III Re-Roofing
ORe-Siding
o Misc.
OAlteration OUtility Connection
I) S J'l K'l/
I hereby certt~fy t I have furnished information on this appl1canon wmcn l~ lU Ul" I.J<;'L v, LUJ ---"--...-6e true and correct. I also certify that I am the owner or
authorized t t or the a v. mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted p (fm a that building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon ~ r erty eded inspections.
X ~ 2tJ 12 ~trfO /2- -fO -() J
OJ' Signature Contractor's License No. Date
I Permit Valuation Z. S-OQ...... I Park Support Fee # $
, Permit Fee $ 14lJ.~ I SAC # $
I Plan Check Fee $' - !WaterMeter SizeS/8";I"; $
I State Surcharge $'- 'Z-5 I Pressure Reducer $
I Penalty $ I Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ lather $
, Gas Fireplace Permit Fee $ I TOTAL DUE $ 7h~ -
dWJ-;~tiT"d : ~~~ ~~J:~r ~;eiptNOJfJ8 ~
I Dat'e ,
......
..,
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I 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
16200 Eagle Creek Avenue Prior Lake, MN 55372