HomeMy WebLinkAboutBuilding 05-0380
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
ADDRESS
/'5/?' ~ 9
se4jL/it/6
Date Rec' d
5 ~. 05-"
I White
2. Pink
Yellow
File
City
Applicant
I PERMIT NO. IJ&. ()3'~
/I t/t::
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z-~ I 4-3. CJS~,. 0
I OWNER
(Name)
. (Address)
(Phone)
BUILDER
(Company Name)
(Contact Name)
JJ a5c)nc,Il/
or 4/ /
-y;; ;; f.-
(Address)
C ru.'k(1 ~,/'-~
blv.J
/ .s 'I 36
TYPE OF WORK 0 New Construction ODeck OPorch
DAddition OAlteration OUtility Conn
CODE: DI.R.C. DI.B,C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
'7(;;3-l!bCf - t "5:56
. .MAI
A/ic.Ic,x" /V( / y
(Phone)
(Phone)
55:Jotl
Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
o Misc.
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certiry that I have furnished mformation on this application which is to the best of my knowledge true and correct. I also certlry that I am the owner or authorIzed agent for the
1hat aU construction will conform to all eXlSlIng state and local laws and will proceed in accordance with submitted plans. I am aware that the building
It for~~e):Jl~more, I hereby agree that the CIty official or a .-:;eslgnee may.enter upon the property to perform necded mspecllons.
X ~ /_<./~ :;'6~g7167 S/'-l/O('
Signarure 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 $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
Butldll1!! Ofticlal
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&-O{)
".OC)
.:f (, r
ThiS IS to certlry that the request m the above apphcallon and accompanYing documents IS In accordance wIlh the City Zoning Ordinance and may proceed as requested. ThIS document
when SIgned by the City Planner conslltutes a temporary Certificate of Zonmg comphance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be
isslIed
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