HomeMy WebLinkAboutBuilding 05-0895
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
9./~ .o.-s-
(Please
ADDRESS
/4-&53
(j'iCAOU I&D~
I White
Pink
3 Yellow
I PERMIT NO. tJ5-. () Ifrl
File
City
Applicant
ZONING (office use)
;leIS 0
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID zs: Z f1tP. 03(P. 0
OWNER
(Name)
(Address)
BUILDER
(Company Name)
,
(Contact Name)
(Address)
(Phone)
9 J:l -.J. -.J. c.. 3 (at (.:
'7 J-").. - '7.y' / ~,.,J ~ (' Ci
TYPE OF WORK 0 New Construction ODeck OPorch o Re.Roofing
OAddition OAlteration OUtility Connection
OLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
IV
I
3
V
M
4
A
R
5
II
F
1
III
H
2
I
E
o Mise.
B
S U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I have furnished mformation on this application which IS III the best of my knowledge true anel conect. ] also certify that I am the owner or authorIzed agent for the
above.mentlOned property and that all construction will conform to all existmg state and local laws and will proceeel in accordance with submitted plans. I am aware that the buildmg
om a an r oke thiS permit for Just cause Fur e,! heJlCby agree that the City official Dr a designee may enter upon the property to perform needed inspections
.2. [)c - .jb~Y C; J.J. ~ 9. /(. ()....\-
Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
8uilctllH! Otlicial
Date
Park Support Fee # $
SAC # $
Water Meter Size5/S"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $
ThiS IS to certify that the request in the above applicatIon and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner conSl1tutes a temporary Certificate of Zonmg complrance anel allows construction to commence. Before occupancy, a Ccrl1tlcate 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