HomeMy WebLinkAboutBuilding 05-0174
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
r'L-6ASI'9N1 .sT se
ADDRESS
+~z/
3.7.05
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 05.0/74--1
ZONING (office use)
re.z-
LEGAL DESCRIPTION (office use only)
LOT / () BLOCK
ADDITION (J;1~ I'ftJ,pN,
OWNER,
(Name)
(Address)
PID zs: o~ Z. oz..8. 0
rth-1
(Phone) gf.:<. - 1'17 -.s 3~
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration o Utility Conn tion 0 Misc.
CODE: DI.R.C. DI.B.C.
Type of Constnlction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have furnished mformatlon on this application which IS to the best of my knowledge true and correct. I also certify that I am the owner or authof!zed agent for the
above-mentioned pro er and that all constru tion WIll conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official ca e t IS it for Just cause Fu thermor hereby agree that the CIty official or a deslgnce may entcr upon the propelty to perform necded msp' Ions.
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 Permit When Approved
Uuildll1!! Ollielal
Date
Contractor's License No.
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~.DO
Paid
Date
7(,. c.;V
:1. ,.()r-
I ~~ei? a-;;.e 3f-
ThiS IS to certify that the request 10 the above applicatIon and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested ThIS documcnt
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence Before occupancy, a Certlficatc 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