HomeMy WebLinkAboutBuilding 05-0849
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
LEGAL DESCRIPTION (office use only)
LOT '3 BLOCK ADDITION
White
Pink
Yellow
I PERMIT NO.~S - ~ L.{ 11
File
City
Applicant
dV:;12ljJ Tr
ZONING (office use)
03
PID d[>o-
OWNER
(Name)
t:/If1'( :; ~ /,i
(Phone)
~1 .1.2.
f,f7 J. - _:J 7 ~ f
(Address)
fJ7 l r/ c. tV
/
BUILDER
(Company Name)
(Contact Name)
/'0/
(Address) /
[J >( ~ J:1i.' /'J
!(. ~ --.
(',etA/ I..J
[) (~) ~
(Phone)
(Phone)
;'/ :/ ~5 f I ,. tJ J t1 9
(J
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Fimsh 0 Fireplace
OAddition OAlteration OUtility Conne tio
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
II
F
1
III
H
2
IV V
I M
3 4
A
R
5
I
E
o Mise.
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
[ hereby certify that [ have t\lrnlShed mformation on this applicatllln whIch is to the best uf my knowledge true and cOlTeet [also certIfy that [ am the owner or authOrized agent for the
above-mentlOned property and that all construction will co orm to all eXlStmg state and [ocallaws and will proceed in accordance with submItted plans. [am aware that the blllldmg
official can ~.ff permIt fOISt caus ' urthermlll hereby agree that the CIty official or a desIgnee may ~nte~ upon the p~.ope11Y to perform needed mspectlll'X
X /0v ~.~('S//f566 ~7/ rb'"
Contractor's License No Date
Permit Valuation ,~SOlJ,-
Permit Fee $ 14 ~ 15'
Plan Check Fee $
State Surcharge $ ;,~S
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
BuildltH! Ofticlal
Dat~
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 $ 7t,. -
Paid
Date
PJt~-5-'
~~";PtNO .900r- t
ThIS IS to certify that the request in the above applicatIOn and accompanymg documents 1$ in accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the CIty Planner constItutes a temporary CertifIcatc of Zonmg 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