HomeMy WebLinkAboutBuilding 06-1062
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT /11 z. '? IrY (,.
1 White
Pink
Yellow
File
City
Applicant
(Please type or print and sign at bottom)
I ADDRESS
/s7t{( frfMrrtJ- W tV;!
PERMIT NO. Ore..../06 '2-
ZONING (office use)
~{a/:;
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
DOa1
tVn/
(phone) t/(I--;/C;-}{'
tV ;y;rb-j:r
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ~eck OPorch ORe-Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
DAdditlOn DAltera.fio~ DUtility Connection
CODE: !.R.C. DI.B.c. o Mise.
Type of onstruction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
x
IOn on this applicatIOn which is to the best of my knowledge true and mITec!. I also certify that I am the owner ()J authOrized agent for the
" ructlOn will con!tlfm to all eXlstmg state and local laws and will proceed in accordance with sub milled plans I am aware Ihat the buildmg
Furt 'rmore, I he' gree that the CIty official or a deSignee may enter upon the propelty to perform needed lIlSpcctions
II-dfJ-O~
Contractor's License No" Date
Permit Fee
$
$
$
$
$
$
I $
$
Park Support Fee
SAC
#
#
$
$
$
$
$
$
I $
$
$ /
I I
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Sewer & Water Permit Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
TOTAL DUE
This Application Becomes Your Building Permit When Approved
I ~;""'~ II/,~~/{)/.
I ~~~ 1W:i/~'"
Receipt No. G2.t;. 7ff
By 1>r-
ThiS IS to certify that the request In the abuve applicJtlllJ1 and accompanymg documents IS m accordance with the City Zonmg Ordinance and may prllceed as requested TIllS document
when signed by the City Planner constitutes a temporal)' Certificate of Zomng compliance and allows construction to commence Before occupancy, a Certificate of Occupancy mllst be
issued
Planning Director
Special Conditions, if any
Date
24 hour nolicr for all insprctions (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS /5 ,~ I F7eellt tJAlr A,c: #./AJ .
TYPE OF WORK Alt:-W l)E':eIL
USE OF BUILDING ~ F: D-
PERMIT NO. DATE ISSUED 11/2.8#"
BUILDER !t.l'll-lDY /..hJt!:, IIIl1S'r PHONE # .Y+'~ "/~r-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FINAL
(if)
I I
L ?J /;1;/&17
"~/' .,
FOR ALL INSPE'CTIONS (952) 447-9850