HomeMy WebLinkAboutBuilding 05-0718
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
n at bottom)
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Date Rec' d
72&. uS'
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 05. 07f B
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Phone)
OWNER
(Name)
PID ZS: 2-<1 r (I/o/- c;)
(Address)
(Address)
TYPE OF WORK 0 New Construction
DAddition DAlteration
(Phone) 61 ) ...~ '-i r:... /::2 ~ S?
q
DLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.c. o Mise.
Type of Constmction: I II III IV V A B PROJECT COST IV ALUE $ q 00000
Occupancy Group: A B E F H I M R S U (excluding land) ,
Division: I 2 3 4 5
I hereby certify that I have nlfmshcd mfllrma n on this application \\'hich IS to the best of my kno\\'lcdgc true and correct. I also certify that I am the owner Of Cluthonzcd agent for the
. ructHlIl WIll cont(llm to all eXlstmg state and local laws and WIll proceed 10 accordance with submItted plans I am aware that the buildmg
Furthermore, I hereby agree that the City official or a desIgnee may enter upon the propelty to perform needed InSpectIOns
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
13uildlll!! UrtlClal
Date
Contractor's License No.
7-~ 6 "-t:)S--
Date
I P"kS"pport Pee # $
SAC # $
Water Meter SIze 5/8", I", $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ /t?" (4)
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This IS to certify that the request 111 the above application and accompanymg documents is 111 accmdance with the City Zoning Ordinance and may proceed as requested ThiS document
whl'l1 slgncd by the CJty Planner constItutes a tcmporalY CertIficate of Zonmg comphance and allows constructIOn to commence. Before occupancy, a Certificate of Occupancy must be
i."iSllCd
Planning Director
Special Conditions, if any
Date
24 hour notiee for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372