HomeMy WebLinkAboutBuilding 05-0827
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
g, 2..-5'. (jr
(Please type or print and sign at bottom)
ADDRESS
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ttJlfCIf1'1/J1V t-A!
I White
Pink
Yellow
File
City
Applicant
05. 08:2.;.71
PERMIT NO.
ZONING (office use)
LEGAL DESCRIPTION (otftce use only)
LOT
BLOCK
ADDITION
PID
OWNER, '"\
(Name) U~ E.a-.\.c...'t-x~
(Address)
(Phone) ta \. C
BUILDER
(Company Name)
(Contact Name) L..-~('~
~~~
~~
q ~2- LIZ- to.,,~
(Phone)
(Phone)
(Address)
TYPE OF WORK 0 New Construction ODeck OPorch ,.Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Conne I
CODE: OLR.C. OLB.C. o Misc. ----..-.-
Type of Constmction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certily that I have hlrmshed mformation on this application which is to the best of my knowledge true and correct. I also certIfy that I am the owner or authorIzed agent llJr the
above- . tI 'd property and that all CDnstructlon WIll conform to all eXlStmg state and local laws and will proceed m accordance with submitted plans I am aware that the buddmg
official C 1 ' tillS permit for Just cause Furthermore, I hereby agree that the City official or a designee may enter upon the propel1y to perform needed mspectlons
?-o S '2--0-7 Y. ~ B( z.,~l os-
Signarure 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
Huildlng Omcial
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 $ 7(,. /2)
,
ffef'~
Paid
Date
7(". fA}
't'. V,<.I"'-
I~~O
ThiS IS to certify that the request in the above application and accompanYlOg documents is m accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the Cay Planner constItutes a temporary Certificate of Zonmg complIance and allows construction to commence. Before occupancy, a Certltlcate of Occupancy must be
issllcd
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