HomeMy WebLinkAboutBuilding 05-0668
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
Date Rec' d
-r 13. CiS
While
Pink
Yellow
File
Cltv
Applicant
I PERMIT NO. 05. 0&&,1; I
349 S .s P JUI (!;6 7Jl, L
ZONING (otTIee use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
H/~
PID 25: 17Z,O~9. 0
ST/U//?GL,
(Address)
(Phone)
BUILDER () It . JJ. , ~v 1!. 'L.h~
(Company Name) ~o lILt t~~Zf:; t.. f/ 1 b6{!I"J
(Contact Name) ./. f' II/.....~ 1 ~.
(Address) t Y J L- OlvS . .5 i E.
(Phone)
(Phone)
1'J:2- 2//Z- .73/1
.
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding DLower Level Fimsh 0 Fireplace
DAddition DAlteration DUtility Conn ctl n
CODE: DI.R.C. DI.B.C. o Mise --"---
Type of Construction: I II III IV V A B PROJECT COST /V ALUE $
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 hlrnlShed Information on this application which IS to the best of my knowledge true and correct. I also certify that I am the owner Dr authOrIzed agent flJr the
above.mentlOned property and tl t all e struction will conform to all existmg state and local laws and will proceed In accordance with submitted plans I am aware that the blllldmg
'x'ftiCial can.,' ~,ke JH7t sperm ust Ise Furthermore. I hereby agree that the City official or a deslgnee may enter upon the propelty to perform needed ~~/('~l
VI / ;/ ?15-
Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildlll!! Ufticial
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # I $
Builder's Deposit $
t; $
TOTAL DUE $ 71;'.00
417sV
ThIS IS to certify that the request 111 the above applicatIon and accompanYIng documents is In accordance WIth the City Zoning Ordinance and may proceed as requested. Tim document
when signed by the City Planner constItutes a temporaIY Certificate of ZonIng compliance and allows constructIon to commence. Before occupancy. a CertIticate of Occupancy must be
issued
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