HomeMy WebLinkAboutBuilding 05-0630
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
/IP9fJO
{-V I L~ (,./0 tc/
Date Rec' d
7 /. os-
I White
Pink
Yellow
File
City
Aprlicant
I PERMIT NO. 05. () (;,3 () I
L-tJ
ZONING (oftice use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID -Z-i;-: 2--f-r. oJ Z 0 I
OWNER
(Name)
tv\\~ \(\Az.~l~
I BUILDER _11\ .^/\ 61 . \) ^ r' J A. A. ' _ 0 f r I ^ . .: 0
I (Company Name)]\Y Y K.;Vl ~, MVvt, CUl U~,~ (Phone)
I (Contact Name) \2..0\0 ~f\(\ (Phone) \1,~ - dd--\ - O?:>t.t5-
<6\ \DO tR. ~ W S~ 00 ~6SS StVJ
(Address)
(Address)
TYPE OF WORK 0 New Construction ODeck DPorch
DAddition DAlteration o Utility Conne
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
(Phone) q'5 z- -;;. ;). & _ c:;171 0
I
q3iZ --L/ 41- S 01 ~
e-Roofing
Ion
ORe-Siding
fv\N 55=61
DLower Level Finish
o Fireplace
o Mise.
A
R
5
B
S
PROJECT COST IV ALUE
(excluding land)
$
u
x
I hereby certify that I have tllrntshed mformatlOn 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 t"r the
above-mentIOned property and that all construction WIll conform to all eXlStmg state and local laws and WIll proceed in accordance with submitted plans. I am aware that the buildrng
officia an revoke thiS ermIt fOr)1 t ause ur ermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propel1y to pert(Jrm needed IIlSpeCtloos
(A . 7-1-05
Signature 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 I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Bill I dill !! Ollicial
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 ~ .()CJ
,
ThiS IS to certify that the request rn the above applicalIon and accompanyrng documents is in accordance WIth the CIty Zoning Ordrnance and may proceed as requested. ThIS document
when signed by the City Planner constItutes a tcmporalY Certificate of Zomng compliance and allnws construction to commence Before occupancy, a Certificate of Occupancy must be
isslled
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