HomeMy WebLinkAboutBuilding 03-0731
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3 _ Yellow Applicant
PERMITNO.t?3- 13/ I
~v,\ N 5S3-1Q
ZONING (office use)
f( (S 0
SpC~'"'5 Lc~\:l~ 'Kd ) Pr~oC L (;\, \.(<i
LEGAL DESCRIPTION (office use onl~
J ~ 9- IJt CJ r= /I <1- I ~
LOT BL6cK ADDITION
PIQ)5- /8/- 00 q - 0
OWNER
'-\ .
(Name) ~) \ f i /. 1''''-'
"11'-.1 c\ t=
(Address)
(' .
.:::> ( \_ 'N"- iJ.
(Phone) q 5 ;J - Lj q (; , ~(; J. c:l
BUILDER
(Name) Cj ('>':'-\ \ 0 L IJ... - Fn \,i i'\ (h '~c(',G \ ,..... ()
(Contact Na~e) 1=\ r"- n... I l: N.... ,
(Address) cJ 3 D \ E c~ td- S \ v.... ('~ "', Q" t J c:lC I'-'h" (._\) 0 ( I ~
TYPE OF WORK
o New Construction
DDeck
DLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $1 G J. V . (.)0
I hereby certifY that I have furnished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or
authorized agent for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted pIa . I am aware t the building official can revoke this permit for just cause, Furthermore, I hereby agree that the city official or a designee may
enter upon e op 0 p fo ed inspections.
,/'
//
lisc.
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Permit Valuation cJ.SOO ,-
Permit Fee $ 7'-/,7S
Plan Check Fee $ /"dS'
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
Building Official
Date
(Phone) ~ I ~ -T::J;:J - -1/ ::1 C(
(Phone) <;; 'eJ - d I (, qq I ;;J,
\--~\ N 55'-i 0 6
DPorch
e- Roofing
ORe-Siding
DAddition
o Alteration
DUtiIity Connection
000 I L; ~.3
Contractor's License No.
OG
oLJ Ins
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $ 2f'
TOTAL DUE $ ?t, .()O
$d?:~
I ~~Ceirp; /;'-15"'1 g-
Paid
Date
_ ...s is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This 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
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372