HomeMy WebLinkAboutBuilding 05-0409
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
Date Rec' d
1 White
Pink
Yellow
I PERMIT NO. (}/}-Lf01i
File
City
Applicant
if s- tS
1~~10~.
ZONING (office use)
LEGAL DESCRIPTION (office use only)_...
/'7 7
LOT 16 ~lOCK "3 ADDITION L!-tuLw
OWNE
(Name)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
TYPE OF WORK 0 New Construction
DAddition DAlteration
CODE: DI.R.C. DI.B.c.
Type of Constmction: I
Occupancy Group: A B E
Division:
II III
F H
1 2
IV V
I M
3 4
t1~oI- {13 .J. -0 I
90drY9JcJ73
PID
A
R
5
. c;J Fireplace
~ .
o Misel '~mOtib e:.iI~00
PROJECT COST /V ALUE $ ~I -- )
(excluding land) ;;;.. ~()L.
B
S
U
I hereby certify that I have hlrmshed mt()rmation 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 for the
JboVC-mentlLlned property and th.at all constl~n will conform to all eXIsting state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
;"'"' "" "",J. . .. "'0< ",,, '""" r "j" , hn,h, ",,, <h" <he "" ""00,'". .,:" m.,,~ 6" '"'3'" '" ""'j? Z" '::i5S"'"' 'k 3-
gnature Contractor's License No. ~
Permit Valuation ~ IJ Or) .--
Permit Fee $ 7C/,7.S-
Plan Check Fee $ / r J-.5
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Building Onicial
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~.
I ~;0:'1I?139
~~~ ?g: ~ 1- L)-'
ThIS IS to certify that the request m the above applicatIOn and accompanymg documents is m accordance with the City Zoning Ordmance and may proceed as requested TillS document
when signed by the City Planner Cllnstltutes a temporalY Certificate of Zonmg Cllmpliance and allows constructIOn to commence. Before occupancy, a CertJticate 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