HomeMy WebLinkAboutBuilding 05-0359
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
ADDRESS
9s-1
LEGAL DESCRIPTION (office use only)
LOT;2..... BLOCK 3 ADDITION
Date Rec' d
White
Pink
Yellow
I PERMIT NO. {)5- - 3S~
File
City
Applicanl
I
E
II
F
I
III
H
2
IV
I
3
V
M
4
'r
ZONING (office use)
;e(
Rt a!aLQ/
/~
PID ~.~~- C);)-l- (j
OWNER .t/ fY/;
(Name) ^~W '/Il./M-
(Phone)
YC;;;L -'-1'17-28':&
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding
OAddition o Alteration OUtility Conne tion 0 Misc.
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group:
Division:
A
B
OLower Level Finish
o Fireplace
$ ~ 5'00 ---
A
R
5
PROJECT COST IV ALUE
(excluding land)
B
S U
I hereby certify at I have htrntshed mformation on this application which is III the best of my knowledge true and correct. [also certtfy that I am the owner or authonzed agent for the
above-mentlO d property and that all onstruction will conform to all extsl1ng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official ca evoke this permit for .v use Fll1thermore, I hereby agree that the Ctty official or a designee may enter upon the property to perform needed mspectlOns
S-/L/oS
Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penahy $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildml! Ofliclal
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 $ I/{o-, ---
~~~ -;~~;;
Receipt No,l/K/ _~ ()
By :J-
ThiS IS to certify that the request in the above application and aecompanying documents IS m accordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the City Planner constitutes a temporary Certificate of Zomng compliance 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 inspeetions (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372