HomeMy WebLinkAboutBuilding 05-0746
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
n at bottom)
9/0/ /11/'1:;'
/v 7(}.J
Date Rec' d
01 J-
() . l-- ~C
I White
Pin!.;
Yellow
I PERMIT NO. 05. o'~h I
File
City
Aprlicanf
ZONING (office use)
LEGAL DESCRIPTION (omce use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
PID Z,S Ilf. 6 ell" 0
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
noo fit1j_
aooM f
;1reu)e(
I~'J " Ic.e
.. W
~7Y1 C. (Phone) LfCj d .~ lfrJ-_
(Phone)
dfd~J\ mtV S555
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration o Utility Conn tIon
CODE: OLR.C. OLB.C. o Mise
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 certify that I have hlflllShcd mformation on this application which is to the best of my knowledge trlle and correct. I also certIfy that I am the owner or authorized agent for the
ab<lve-mcntlllned property and that all constructIOn will conf()rm to all cXlStlOg state and local laws and will proceed 10 accordance with submmed plans I am aware that the buildmg
~liClal can rem - tillS permIt for Jus:use Furth' -more,:'herebY agree that the City offIcial or a de -lgO/ma e;/I~o7 tl?eI1Y to perform neede'?lAnj oS--
Signature Contractor's License No_ Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
Mechal11cal Permit Fee I $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
BuddIn!! Orticial
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 $ I"J~_O ()
ThiS IS lu certIfy that the request m the above applIcatIon and accompanymg documents IS m accordance wIth the City Zoning Ordinance and may proceed as requested_ TIllS document
when signed by the CIty Planner constItutes a temporary Certificate of ZOnIng 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