HomeMy WebLinkAboutBuilding 05-0345
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
". ""l .--""
d- ? ~). C/"
7 . c:;. '.. J
File
City
Applicant
[ PERMIT NO. .26-, OJ4-:;-
White
Pink
Yellow
at bottom)
(Please
ADDRESS
"~5"5
;' -../. 8--
/?i (.) ~E' /"7 CJ/lj I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2";: lJ Ef(;. Ci () l 0
OWNER
(Name)
(Phone)
LI"-I7- 32.72-
rL EL. iC..
F--I C.U At2.1J
(Address)
/$5'rt!s-
BUILDER
(Company Name) i..G..t1='ry € () c "- c, (' .i1 U<, "r
(Contact Name) lLfL a....l f;"L I .. J) tc'-L .J
(Address) l \..:,(l L(' S. L IV I.HL
(Phone) c1S'Z - L/i--!7 -jW3L
(Phone)
L.t~Kk P'#4- SS-:S',
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition o Alteration OUtility Connection 0 Misc.
CODE: DI.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
PROJECT COST IV ALUE $
(excluding land)
III IV V A
HIM R
2 3 4 5
B
S U
I
E
II
F
I
I hereby certify that I have 11lrnished mformatlOn on this application which is to the best of my knowledge true and correcl. I also certify that I am the owner or authorized agent for the
above-mentlOned property and that all construction will conform to all existIng state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
offIcial can revoke this permIt for Just cause Furthermore. I hereby agree that the City official or a designee may enter upon the property to perform needed mspectlons.
"- ~-------
x
'Z 5'()J). vi)
Park Support Fee
SAC
#
#
Contractor's License No.
Permit Valuation
Permit Fee
$
$
$
$
$
$
$
$
TOTAL DUE
Plan Check Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
Y - L 1 - oS-
Date
$
$
$
$
$
$
$
$
$
~_ (IV
This Application Becomes Your Building Pennit When Approved
Bllildll1~ Otlicial
Date
~;qIJ'/ /
ThIS IS to certify that the request in the above applicatIon and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThlS document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be
issued
Special Conditions, if any
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372