HomeMy WebLinkAboutBuilding 05-0647
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
at bottom)
uv8 7?t<.-_
54-~ 0 C'/J7VO,/
11, (,IS
1 White
Pink
Yellow
File
City
Applicant
I PERMIT NO. rJ50h+71
ZONING (office tlse)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) 13vrcH
/(cLL 1/
/
(Address)
PID 2-5-. oz 7. () /2-.0
(Phone)
I
I BUILDER ~ /' ,. .
I (Company Name) J JlE' borYlEA CD~
I (Contact Name) SErf /6:-E/.e~'
(Address)Z 76/ -.:> 6'L!! ~ vL: S .
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Conne
(Phone)
(Phone)
.//----,-/
Cll-33/-/553
Y7N 5.5J./O
ORe-Siding OLower Level Finish 0 Fireplace
CODE: OI.R.C. OI.B.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
I hereby certily that I have hlrnished mformatlon on this application which is to the best of my knowledge trtle and correct I also certify that I am the owner or authOrized agent I"r the
above-mentIOned . perty n that all constructIon WIll co . rm to all eXlstmg state and local laws and WIll proceed in accordance with stlbmltled plans I am aware that the buildmg
official can rev ' his for Just caus ' urt her agree that the CIty offIcial or a deSignee may enter upon the propeny to perform needed mspe lllns
'/\ r~
X U~
Contractor's License No.
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
Date
Huildlllg Otlicial
S"k Support Fee # $
SAC # $
Water Meter Size 5/8", I", $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7t. 0 0
[Paid
Date
This IS to certify that the request m the above application and accompanymg documents IS m accordance WIth the City Zoning Ordinance and may proceed as requested Tim document
when signed by the CIty Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence Before occupancy, a CertIficate 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