HomeMy WebLinkAboutBuilding 02-1111
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
9-- ?..-~ 2-
~i~i~e ~:~y I PERMIT NO. /12--/ /1 /
Yellow Applicant (j4 / / ,
ZONING (officeusel
/5Sef-~
Lfi-/?6// / t3 w U /Z-
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
OWNER
(Name)
PIDZ5""" - /SI- d 61 - 0
(Phone)
(Address)
BUILDER
(Name) ,t ~ (\!
(Contact Name) t..
(Address)
"'-
/~ (7) f"-" 5 (
l?C)J f /(v-u e7 e\J
~/r7- Yt.t ;;73
(Phone)
(Phone)
TYPE OF WORK
ODeck
e-Siding
o New Construction
DLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
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 aware that the building fficial can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the pro rty to perform n ed 1 s ctions.
'L ---" .....(..,
Signature
o Misc.
x
Permit Valuation 21 s:- d' 0- (,.Z)
Permit Fee $ 7L{7.J'
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
JUfi4- 1 -7" u7.---
Date
Building Official
OPorch
ORe-Roofing
OAddition
o Alteration
OUtility Connection
Contractor's License No.
or(09/CJ '::(
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~' VZ/
~V'U~
- -1-0 .-
1~~~:ZN1
Paid
Date
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