HomeMy WebLinkAboutBuilding 02-1201
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Date Rec" d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
0ord~f'J A t/C-
~/3u
LEGAL DESCRIPTION (office use only)
LOT
OWNER I
(Name)
(Address)
BUILDER
(Name) U . C . ' .1 -Q
(Contact Name) 1./1 n 'yo
(Address) I (" (' 0 . ,:70 r (1ct;1~
TYPE OF WORK
o New Construction
ODeck
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
OAddition
o Alteration
OUtility Connection
o Misc.
White File I PERMIT NO
Pink City . ~ ) _ ;" 1 11 /
Yellow Applicant , L/~ _~
ZONING (office use)
f~
PID~5'" O(JlI-()d-/-O
(Phone)
(Phone)
(Phone)
DPorch
ORe-Siding
e-Roofing
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 plans. I am a e that the b . a' g official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the pro to erfor ne e . spections. ..
/;3 C' /)r ,F/~'
x
Permit Valuation :;;2g){)- -----
Permit Fee $ -; L/ ::"/5'
Plan Check Fee $
State Surcharge $ J~;)..)
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
Contractor's License No.
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 $ 7(:,OU
Paid
Date
1f,ig~~
I Rece~~o~ 'IJ, f?'l f:
By j.{'./
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, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372