HomeMy WebLinkAboutBuilding 05-0820
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
/0/1
-
U Ie.. ~
/7 / ~ Cj
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
L.
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
r J1.. 9
(
TYPE OF WORK 0 New Construction ODeck
OAddition OAlteration
CODE: DI.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
Date Rec' d
r.Z~. oS-
I White
Pink
Yellow
I PERMIT NO. as. 08Z0 I
File
City
Applicant
ZONING (office use)
PIDZ,S-.
o
(Phone)
7"'52- yY?- 00(3
(Phone) "1 f ~ ~ ~~ -<:J (1 Y3
(Phone)
J1/f.~
OLower Level Finish 0 Fireplace
o Misc.
B
S U
/ ~ 5'3"0
PROJECT COST /V ALUE
(excluding land)
$
o this appl' atlDn which IS to the best of my knowledge true and correct. I alsll certifY that I am the owner or authOrIzed agent for the
I'm to all existmg state and IDeal laws and will proceed in accordance with submitted plans I a aware t the bUlldmg
ereby agree that the city official or a deSIgnee may cnter upon the prOpclty to perform needed msp, ctlOns
(; '7 Y ~'J, t
Contractor's License No.
x
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 Olflcial
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
ThIS IS to certIfY that the request in the above applicatIon and accompanymg documents IS m accordance with the City Zoning Ordinance and may proceed as requested TIllS document
when signed by the City PI,lnner constltutcs a temporary Certificate of Zoning compliance and allows construction to commence Before occupancy, a Certlficate of Occupancy mllst 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