HomeMy WebLinkAboutBuilding 05-0205
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
3 . Z ':I ()5
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 05. iJ 2-L) r.)
(Please at bottom)
ADDRESS
ZONING (office use)
~I
/52+6 N/I./OJ
tf? ,t:/t.1/ V
LEGAL DESCRIPTION (office use only)
LOT /1 BLOCK z.. ADDITION
l'b', LO j J{)U'IJ-I
PID 2 s--: :.3 ez . 0 ':.J-4-. ()
OWNER
(Name)
(!4 IV tJr P/&IuIL tfi~~
/
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe.Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition o Alteration OUtility Connection 0 Misc.
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
B
S U
PROJECT COST/VALUE $
(excluding land)
I h 'Tby certify that I have furnished mformation on this applicatlon which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
db vc entloned property and t all construction Will conform to all existmg state and local laws and will proceed in accordance with submittcd plans. I am aware that the build 109
~. iaI an~oke this permit for IS ause Furthermore, I hereby agree that the City official or a designee may enter upon the property to perform ~:pectHlns
Contractor's License No.
Park Support Fee
SAC
#
#
Sewer/Water Connection Fee
#
#
$
$
$
$
$
$
$
Permit Valuation 7 S 00,0 (]
"-
Permit Fee $ 4.1~
Plan Check Fee $
State Surcharge $ ..5 ()
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Water Meter Size 5/8"; 1";
Pressure Reducer
Water Tower Fee
Builder's Deposit
Other
This Application Becomes Your Building Pennit When Approved
Paid
Date
. 0)
.J z J. (\
TOTAL DUE
Buildlllg Official
Date
ThiS IS III certify that the request 10 the above applicatIOn and accompanying documents is In accordance with the City Zonmg Ordinance and may proceed as requested. TIllS document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence Before occupancy, a Certificate of Occupancy must be
isslled
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