HomeMy WebLinkAboutBuilding 05-0747
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
n at bottom)
2 9'00
s:z .oE;
I White
Pink
Yellmv
I PERMIT NO. {)5-.()7~ I
File
City
Applicant
ZONING (office use)
c~-~,
ILEGAL DESCRIPTION (office use only)
l_ LOT BLOCK ADDITION
PID 2.S- J33 (>0 G. 0
OWNER
(Name)
(Address)
(Phone)
BUILDER
(Company Name)
(Contact Name)
(Address)
h(wser
fI/} I J62
&SO W
h.tJh'1 J
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Con nee
J:r1 c
95a -qq
(Phone)
(Phone)
~
mAl
ORe-Siding OLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.c. o Misc.
Type of Constnlction: 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: 1 2 3 4 5
I hereby certify that j have hllnIshed mformation on this applIcatIOn which IS to the best of my knowledgc truc and correct. j also certify that I am the owner or authollzed agent Itll the
Jhnvl'-mcntlOl1cd property and that all cunstruction will conform to all CXlstmg state and local laws and will proceed in accordance with submitted plans_ I am aware that the building
"tflclal can revoke tillS permn ttll Just cause Furthermore, I hereby agrec that the City official or a designee may enter upon the propel1y to pcrform needed InSpectHlns
X I1CLdr~~~ //)~~7'- _ dU/)5/'iS-- g--/~/O)
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
i Penalty $
! Plumbing Permit Fee $
I Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildlllg Ortleial
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water ConnectIOn Fee # $
,
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ ~&. rl)
ThiS IS to certify that the rcqucst in the above applicatIon and accompanY1Og documents is 10 accordance with the City Zoning Ordinance and may procccd as requested ThiS document
when signed by the CIty Planner wnstItutes a temporalY Certificate of Zonmg complIance and allows constructlon to commence. Bcfme occupancy, a Certlticate of Occupancy must be
isslled
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