HomeMy WebLinkAboutBuilding 05-0913
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
LA./ S lJ
LEGAL DESCRIPTION (office use only)
-
LOT /?BLOCK
Date Rec' d
White
Pink
Yellow
I PERMIT NO. !JS- 9 I ~ I
File
City
Applicant
ZONING (office use)
ADDITION
PID
OWNER
(Name)
(Address)
(Address)
S~tL') +foltt.{tf..
~~W'-tL
~(1- LAl<.e. 4....[)
BUILDER
(Company Name)
.-cJt
g-03~
(Phone)
1'$).. - )~b ~ S770
(Contact Name)
~~ ILav-t.. ~.e...6'lT
I
I ,
YVlJ
(Phone)
(Phone)
y)""
1&J~ 5"37 - 77 <fj'"
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing .~Re-Siding OLower Level Finish 0 Fireplace
OAddition o Alteration OUtility Connection
CODE: DI.R.c. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
o Misc.
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
~l'by rcrt that I have tiJrnished Information on this application which IS to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
I ab<lve-men on d property and that all cunstruction wIll conform to all existing state and local laws and will proceed in accordance with submitted plans. [am aware that the buildmg
"ffiCla[ can vo e t IS per It JU cause Furthermore I hereby agree that the City official or a deSignee may enter upon the property to perform needed mSpeCIHlI1S
o..D- Be.... ;1-00'1 OC>t 1
1-.fhlS lS to ccrtlfy that th.C request in the above applicatIon and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. Thls document
I when signed by the City Planner constItutes a temporary Certificate of Zonmg complrance and allows construction to commence. Before occupancy, a CertIfIcate of Occupancy must be
I Issued
I
I
L
x
Signature
Permit Valuation 01.5 t1:?- -
Permit Fee $ Ill, 7~
Plan Cheek Fee $
State Surcharge $ 1/ ;)5
I Penalty $
! Plumbing Permit Fee $
r Mechamcal Permit Fee $
~ewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
Dale
BuildltH! Ollicial
c(-;2.o-oS-
Contractor's License No.
Date
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 $ 1I.P--
~~:e /) $----XJ
,') ,iP1No50!J)[r
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