HomeMy WebLinkAboutBuilding 05-0791
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
34 q 3 j-\, oo€-l~
PO~H) ,IZ.L
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
rt+UL CUL\Jf.ll
~G) q S
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
4J1J
vi IZ... \
fit-, f ObfiS
.~ lL\ FOb~S
Date Rec' d
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. O$-l~
ZONING (office use)
PID , <,... Z-~S.....t)2-3> -0
(Phone) Y-"-l 0 -
UtJ S-r
b 3'3S'
(Phone)
(Phone)
4<-/7-) 83L
ORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility ConnectIOn
CODE: I.R.C. DI.B.c. o Misc. ....0l-rL -v~F
Type of Constmction: 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 hlrnlShed ml()rmation on this application which is to the best of my knowledge true and correct. I also certlly that I am the owner or authorIzed agent lor the
above-mentioned property and that all construction will conform to all eXIstmg state and local laws and will proceed in accordance with submitted plans I am aware that the bUlldmg
offiCial can revoke thiS permIt for Just cause unhermore, I hereby agree that the Clry official or a deSignee may enter upon the property to perform needed mspcctlons
C
X
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace ermit Fee ,
Contractor's License No.
Park Support Fee
SAC
#
#
Date
$
$
$
$
$
$
$
$
$
Paid
Date
1!r,~ '( c<)
\ ~~ceiPt Nr4l ~4
Water Meter Size 5/8"; 1",
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
ThIS IS to certifY that the request m the above applicatIon and accompanymg documents is m accordance with the City Zoning Ordinancc and may proceed as requested. ThiS document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows constrUCtIon to commence Bcfore occupancy, a CertIficate of Occupancy mLlst be
issucd
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-.U45
16200 Eagle Creek Avenue Prior Lake, MN 55372