HomeMy WebLinkAboutBuilding 05-0051
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
at bottom)
WILl-OW
L/lAle
/fp B 4-3
Date Rec' d
1.1+, tJS
White
Pink
Yellow
I PERMIT NO. 06, 005/1
File
City
Applicant
sw
ZONING (office use)
;e/
LEGAL DESCRIPTION (office use only)
LOT ~ ~BLoCK
(II//UOWS
ADDITION
~rn
PID25. z4-fj, 0/3, 0
OWNER
(Name)
(Phone)
(Address)
(Phone) I~ J 7-- V;J L-/_ 351') r/
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration o Utility Conne tion 0 Misc.
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
II
F
I
I
E
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST /V ALUE $
(excluding land)
I hereby eerllly that I have turnlshed ml(Jrmation on this application which is to the best of my knowledge true and correct. I also certIfy that I am the owner or authonzed agent for the
,lbove-mentlOned property and that all construction will conform to all existlOg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
"ftlcial can revoke thIS permIt for Just cause Furthermore, I hereby agree that the CIty official or a deSignee may enter upon the propelty to perform needed tOspectlons
x
Signature
Permit Valuation Z, 500,00
Permit Fee $ 74. 1S
Plan Check Fee $ -
State Surcharge $ J.2-5
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildll1g Official
Date
2622 &. -) I...J ~
Contractor's License No.
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 $ '10. ()()
Paid
Date
'7(, 00
1/ {~, rJ5
I ~~ceiP".!' ..":I
ThIS IS to certIfy that the request in the above applIcatIon and accompanying documents is m accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner conslllutes a temporalY Certificate of Zomng complIance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be
isslIcd
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