HomeMy WebLinkAboutBuilding 05-0940
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF WNING COMPLIANCE.
AND ~ITY CONNECTION PERMIT
Date Rec I d
tj Z3. ()-S
-~--~~._~
IAD~ /-- th · u1
I. White Fil. I PERMIT 0
2. PInk city N . o $;, o9.:f()
) VoIIow Appli..... .
I ZONING (office use)
,/J1Al .
.
/' ~/V" L~e?
LEGAL DESClUPTION (office use only)
TYPE OF WORK 0 New Construction DDeck DPorch ORe-Roofina
OAddition OAlteration Dutllity Connection
. CODE: OUt.C. OI.B.C.
Type of Coastnadion: I
Oa:apaacy Group: A B E
OiYiJioa:
LOT
BLOCK
ADDmON
1J:e
7f~
BUILDER ~ I' J
(Company Name) _ hp.jll!tt::, IlT.
(Contact Name) . T S?tI tvl r;ren '/
(Address) 3 Sc.'jiJsd t<~)
n mIVVAB
F HI MRSU
1 Z 3 4 5
PID Z S~ 675. {jtJ2 _ 0
(phone) (P/~ - JZ61/ - :3) ()[?
f? 'I i I:::,
<'fJL ~
iding DLower Level Finish
D Fireplace
PROJECT COST/V ALUE S
(exducliD& Ian.)
~ 1I/4!J;1 'l!.-
1 hereby certilY lbat I have fumis/ICd informatioll on this application whldl iJ 10 the best of my IcnowIcd8e lI'1Ie &lid comet. I abo certify tbat I am the owner or authorized agent for the
~ """'" ... ... '.0 COIISU\IClIOtI will conform to IU existina state and local Jaws and will proceed in ac:conIanCe with submitted plalls. I am awm that the buUdin,
ofllcial c "1 ror just cause. Furthennote. I hereby aaree tILU the citY oftlcial or a desipee may enter upon the propertY to perform nec:ded Inspcc:tions.
X ~D~D3o~ ~.~~~~~
h;;;;'..._ Contractor's LiceDse No. Date
Permit Valuation
Permit Fee S
Plan Check Fee S
State Surcharge S
Penalty S
Plumbing Permit Pee $
Mechanical Permit Fee S
Sewer &: Watu Permit Pee $
GasPireplace Permit Fee $
This AHlicatiOft Becomes Your Baild1Dl Permit WbaI AppM'MI
Suildin Oft'Icial
Dale
Park Support Pee #I $
SAC ## $
Water Meter Size SIS"; I"; $
Pressure Reducer $
SewerlWater Connection Pee ## $
Watu Tower Pee II $
Builder's Deposit $
Other S
TOTAL DUE $ 7&. iV
ThIS IS to ccrtilY lbat the request ill the above applkltion &lid ac:companyiq documentS iJ in ac:ccrclallce witb the City Zonin, Ordinance and may proceed as requested. This ducumenl
when s1pc:d by the CItY Planner constitutes a tetftPOl'Jry Certillcate of Zonin& c:ompliancc and a1Iows c:onstrUCtion to c:ommenc:t. Before 1lCCIIpanc:y. a Ccrtiflcate of Occupancy must be
issued
PIIDaiII& Direc:tDr
.
Date
24 boar notlte for al1lnspectloas (952) 447-98~. fax (m) 44704245
16200 EasIe Creek Avenue Prior Lake, MN 55372