HomeMy WebLinkAboutBuilding 05-0942
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
n at bottom)
3440
&eAf57A L
CJ K- C-L6
LEGAL DESCRIPTION (office use only)
Date Rec' d
f/2&.O$"
I White
Pink
Yellow
File
City
Applicant
PERMIT NO. ;;. 9~ 2-
NW
ZONING (office use)
,e/SD
LOT
BLOCK 5 ADDITION
L......TH
ISL-flNO Vl6W V
PID 2S.. 2.52...030.
OWNER
(Name)
~&ln&/6te,
,
(Phone)
2/5. 81+8
.JE K.tJH e / C /fflJeAj i-
f
(Address)
,-
i BUILDER
I (Company Name)
I
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration o Utility Conne tlon
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III
H
2
IV V
I M
3 4
A
R
5
o Mise.
B
S
U
PROJECT COST IV ALUE $
(excluding land)
I hereby certity that I have hlrmshed intillmation on this applicatIOn whICh IS to the best of my knowledge true and correcl. I also certify that I am the owner or authorized agent f
ab'lve-mentwned property and that all construction wIll conform to all eXIsttng state and local laws and will proceed in accordance with submitted plans I am aware that the building
:"m , "",,' "" " '"' '"'' '" , c""""~""'. ",,,",,,,,, ","" "" om"" '''' ""'0" =, '",,'"'0" """0"", W ""'oem OS,;8b ';>00 J -:
Contractor's License No Date
Permit Valuation 2,500.00
Permit Fee $
Plan Check Fee $
State Surcharge $
i Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Y OUT Building Permit When Approved
BuildllH! Orticial
Date
1l'11IS IS.' W ecrtlfy that thc request in the above application and accompanying documents IS 111 aceordance wrth Ihe Crty Zoning Ordinance and may proceed as requested. ThIS document
I when signed by the CIty Planner constItutes a tempOfJry Certificate of Zonmg compliance and allows constructIOn to commence. Before occupancy, a Certificate of Occupancy mllst be
I ISsucd
,
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 $
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372