HomeMy WebLinkAboutBuilding 05-0651
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7. I. {/S-
(Please
ADDRESS
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. Os-. () ".5 / ]
/5530
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A:-o.
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
~
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(Phone)
BLOCK
OWNER
(Name)
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I./JA)/A/C
(Address)
PID ZS-: tJ91. 024=-.0
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I
BUILDER
(Company Name)
[Nt JJ;;,/ I"J
(Contact Name) ~ /J7: J':t (\1,
(Address)17~J t:? /:1--. ~.tV
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Con
e-Roofing
ctlOn
ORe-Siding
OLower Level Finish
CODE: OLR.C. OLB.C. o Mise. --~--.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
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/6 :/ . ~9 . (:..; '-' 7
o Fireplace
I hereby certify that I have hlrnished mt()rmation on this applicatIOn which IS to the best of my knowledge true and correct. ] also certify that I am the owner or authOrIzed agcot t(lf the
above-mentIOned property and that all eonstruc .on WIll co 0 to all eXIstmg state and local laws and WIll proceed m accordance with submItted plans. I am aware that the buildmg
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X --A'L" ;;!.,{ij J 5 5- b6 '7/7/ (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 I $
Gas Fireplace PermIt Fee $
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
This Application Becomes Your Building Permit When Approved
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13uildlllg OffiCIal
Date
#
#
#
#
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$
$
$
$
$
$
$
$
$ 7~. OC)
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ThIS IS to certify that the request m the above applicatIOn and accompanymg documents IS 10 aecordance with the City Zoning Ordinance and may proceed as requested TIllS document
when signed by the City Planner mnstItutes a temporary Certiticate of Zon1Og complIance and allows mnstruwon to commence Before occupancy, a Certlflcatc of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (9:;2) 447-98:;0, fax (9:;2) 447-424:;
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any