HomeMy WebLinkAboutBuilding 05-0870
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
~h'73
LEGAL DESCRIPTION (office use only)
LOT /LhLOCK ,tDDITION
OWNER
(Name)
(Address)
\Y4bMLJ
;>
Date Rec' d
J White
Pink
~ Yellow
File
City
Applicant
I PERMITNO.O~lJ?c>1
ZONING (office use)
~ ~)/j.
PID
(Phone) ~~- V~_ 66>1"
BUILDER
(Company Name)
(Contact Name)
(Address)
-ra m ~ \,~Ai5 tkrrvCb:-
(Phone) ~/d- 3d7-05i
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Fimsh 0 Fireplace
OAddition OAlteration OUtility Conne I
CODE: OLR.C. OLB.C.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
o Mise.
A
R
5
B
S
PROJECT COST IV ALUE
(excluding land)
U
$
I hereby certify that I have hlrnlshed mt(lrmatIOn on this application which is to the best of my knowledge true and correct. I also certIfy that I am the owner or aUIllDf!zed agent t'lr the
above-mentIOned property and that all Cllnstroction will conform to all existmg state and local laws and wJ!! proceed in accordance with submItted plans. I am aware that the buildmg
otfjctal can revoke this pelmIt for Jusl c use F'tnthelmole, I heleby agree that Ihe City offiCIal or <l deSignee may enter upon the plOpel1y to peltorm needed mspectlOns
X ;b~3<;/J>cr c;(g(~
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 Permit When Approved
BlIild1l1~ Otlicral
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 $ 74- -
<
~7f-~1 ~
t Paid
Date
I ~~j:&;QJOl- 5' I
This IS to certify that Ihc requcst in the above applicallon and accompanYIng documents IS in accordance wilh the City Zoning Ordinance and may proceed as requcstcd TIllS document
when signed by the City Planner CllnstItutes a temporalY Certificate of Zonmg compliance and allows Cllnstruction to commence Before occupancy, a Certltlcale of Occupancy must 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