HomeMy WebLinkAboutBuilding 05-0693
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7. ZO.O~
File
City
Applicant
I PERMIT NO. OS:o"13
White
Pink
Yellow
n at bottom)
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID zs: zeo. oJ:? 0
BLOCK
OWNER
(N ame)
6u~ ft- ,V
(Phone)
If;;? '1t/7- 5'/~ /
,
:7;' ,.vI
(Address)
I BUILDER ~..,.-.}
(Company Name) W .51. l/fI /-Iv .
I (ContactN,mc) !<;<I^1 -g- j
(Address) 17 t10 / 3~ /It/'! t'
7b.l- :51i-- t1:)~o 9
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe.Siding OLower Level Finish 0 Fireplacc
OAddition o Alteration OUtility Connection
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
o Mise.
IV
I
3
V
M
4
A
R
5
B
S
I
E
II
F
I
III
H
2
U
PROJECT COST IV ALUE
(excluding land)
ion on this application which is to the best of my knowledge true and correct. 1 also certify that I am the owner or authorIzed agent for the
truction WIll confor ] all eXIStIng state and local laws and will proceed in accordance with submitted plans I am aware that the buddmg
Furth ore, I h Y agree that thc CIty official or a deSignee may enter upon the propelty to perform needed ;;2; ~5
Contractor's License No. Date'
x
#
#
I hereby certIfy that I have hlrnlShed mtllr
above. mentIoned property and that all c
official can revoke this t for JU sc
[!ark Support Fee
LSAC
Water Meter Size 5/8",1",
Pressure Reducer
Sewer/Water Connection Fee
Permit Valuation
Permit Fee
$
$
$
$
$
$
I $
$
TOTAL DUE
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
Date
Buildlll!! Of1lcial
$
$
$
$
$
$
$
$
$
$
ThiS IS to CCrtIfy that the request m the above applicatIon and accompanymg documents is ll1 accordance with the City Zoning Ordinance and may proceed as requested. Tim document
whcn signed by the City Planner constItutes a temporary Certificate of Zomng compliance and allows constructIon to commence Befme occupancy, a Certificate of Occupancy must be
Issued
Special Conditions, if any
Planning Director
Date
24 hour notice for all inspeetions (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372