HomeMy WebLinkAboutBuilding 02-1210
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
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~<Je. /\ U~T
(Address)
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C. /.
White File
Pink City
Yel\ow Applicant
PERMIT NO.O
2-('-10
ZONING (office use)
7'-(<;;
PID
(Phone) (9');,1) III 7 - ~ s 7L,
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~~~~~R4r"'ff (1 (":""'--/v'd +"n,
, {
(Contact ~~me).,~ID' +~ ',', ,'y (" v-"
(Address) '-1-'5<:;0; ,Y'.''''-.:J. . '-,- s,
_'::::t.' ,It- ,:::lJ;"'/
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(Phone) (c/5~)
(Phone) (l'
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TYPE OF WORK
ODeck
. oofing
o New Construction
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
OAddition
o Alteration
f;;.
o Misc.
OPorch
o Re.Siding
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
authorize ent for the above. mentioned property and that aU construction will conform to aU existing state and local laws and will proceed in accordance with
sub ed lans. I am at building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon ro t rform needed inspections.
x
Permit Valuation ~c:;;- 00. -.
Permit Fee $ ,A. "1 '\
Plan Check Fee $
State Surcharge $ l~2~
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application B comes Your Building Permit W n Ap oved
.
Building Official
.;;< C' f b '-/I..( (.' ~;(
Contractor's License No.
c- '"l"
I. ,~S - -.;~
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 1 c... ' .-
Paid
Date
(~ ~.
1,;~~
Receipt No. .,.~o 1/
By fUJlr
This 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. ifany
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372