HomeMy WebLinkAboutBuilding 03-0655
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5. 3(~ ()J
White File I PERMIT NO I
Pink City ./},I -;> -0' /_ c;C:-
Yellow Applicant , V""'> (J;'_.J,
ZONING (office use)
/52-01'
F'/1/1G 15/1 Alk_J '--rJP49- / L
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
-::>'" - 601 - 0
OWNER /2
(Name) IJluce
(Address)
UI f112A
(Phone)
15')--I/i.;r;:) -317b
BUILDER
(N ame)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
~ower Lev,el Finish
3 tJ~ ()J'J
DDeck
DPorch
ORe-Roofing
ORe-Siding
~
o Misc. ~
o Fireplace
DAddition
OAlteration
OUtiIity Connection
PROJECT COST IV ALUE (excluding land) $
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 upo~erty toperform geedtjJ. inspections
X y(Y11/ht;:("titwl\ (;'5 - it) ~Q3
Signature Contractor's LIcense No Date
Permit Valuation Park Support Fee # $
Permit Fee SAC # $
Plan Check Fee Water Meter Size 5/8"; 1"; $
State Surcharge Pressure Reducer $
Penalty City SAC and WAC # $
Plumbing Permit Fee 0. - Water Tower Fee # $
Mechanical Permit Fee Builder's Deposit $
Sewer & Water Permit Fee Other ELC:C-- ?Bl-",-, rr:. $
TOTAL DUE $
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
Residential Building Permit Checklist
/!f'ement Finish or Interior Alteration iSinfe Family Homes
(2!) t'tJ Date: ,:; I ~!,.J :'>
BY:
Building Permit # tJ 3> . c,S-~
Site Address
PID:
Zoning: I!. . /5f)
Legal: L B
Existing Strnc~O
I CONFORMS TO ZONING
. ORDINANCE
Subdivision:
IGV I
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? .,/
Is the property located within the flood plain? Refer to Planning ~
Does the alteration include any additional kitchens? Refer to Planning V""
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? V-
Is the proposed use of the [mished space or Refer to Planning
alteration for anything other than a normal single ~
family home (office, lITOUD home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L\TEMPLA TE\AL TCHCK.DOC
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