HomeMy WebLinkAboutBuilding 05-0868
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
5 d-/J
LEGAL DESCRIPTION (office use only)
LOT
LOCK:3 ADDITION
Date Rec' d
I White
Pink
J Yellow
PERMIT NO.O~ -
[08"1
File
City
Applicant
)~+-
ZONING (offIce use)
PID tfOd.-O:'J
OWNER
(Name)
I<~ kkAr
(Address)
(Phone)
m W7 0g>3
BUILDER
(Company Name)
(Contact Name)
(Address)
~V~~l-
(Phone)
(Phone)
6(;2 ~2) V/~
6(2- 5:2? Y/gy-
TYPE OF WORK D New Construction DDeck DPorch
DAddition DAlteration DUtility Conn CtI
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
III
H
2
IV V
I M
3 4
A
R
5
I
E
II
F
I
DLower Level FinISh D Fireplace
o Misc.
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certifY that I have hlrnished mfmmatlOn on this applicatIOn which IS to the best of my knowledge true and correct I also certifY that I am the owner m authorIzed agent for the
above-mentIOned propcrty and that all construction will conform to all eXlStmg state and local laws and will proceed m accordance with submilted plans I am aware that the blllldmg
~rlcial can revok~Furthermore, I hereby agree that the City official or a deslgn~?;357.3P9rm needed mspecif'~~
Signature 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 I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildlllg Ofticial
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 $ ~(r; .-
I R"~t N O-.J~C::>()d<5
By __
Paid
Date
~".-
. -7 -<;'--
This IS III cemfY that the request in the above applicallon and accompanymg documents IS In accordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows construcllon to commence. Before occupancy, a Cerllticate 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