HomeMy WebLinkAboutBuilding 05-0618
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
34-/5
sy- efi/"1 Olt-e;
Date Rec' d
,-
(;, . J O~ O.;;r
] White
Pink
Yellow
I PERMIT NO. oso~/f31
File
City
Applicant
-;7tR/ L-
ZONING (office use)
;CArD
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
5 "<./1
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
~ '-( ,,(4'k.( r? /I
,,-7: ~ /1
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51
TYPE OF WORK 0 New Construction ODeck o Porch
OAddition OAlteration OUtility Conn
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
I
PID '2S': 0 'f /. (j!tp . 0 I
(Phone)
(Phone)
(Phone)
u/2 -..;:>" 7-7/:; 7
ORe-Siding OLower Level FinIsh 0 Fireplace
o Mise.
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I have hlrnished mfo - atia on this application wh1ch is to the best of my knowledge true and correct. I also certIfy that I am the owner or authOrIzed agent for the
dbove-mentlOned propeqy and that all nstr t!On will conform to all'X1Sl1ng state and local laws and will proceed in accordance with submItted plans. I am aWdl'C that the buildmg
r Just ause urthermore, I hercby a . e that the City official or a designee may enter upon the propcI1y to perform needed mspectlllns
X _MfLf .
Contractor's License No. D~
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildlllg Onicial
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 $ 7~. (/L)
ThIS 1$ to certify that the request in the above applicatIon and accompanymg documents is 111 accordance with the City Zoning Ordinance and may procecd as requested TillS document
when signed by the City Planner constItutes a temporalY Certificate of ZOnIng 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