HomeMy WebLinkAboutBuilding 02-0562
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
~j~j~e ~:;y I PERMIT NO./) J -5-/ 1 I
Yellow Applicant , f.-/c:;Jt-. CO ~
(po5'? ~(i
I e.-.c!reeJL
Uc- Sc
ZONING (office use)
rsj)
LEGAL DESCRIPTION (office use only)
LOTd qLOCK ADDITION
akesJdc-
PID~~ (J {.
OWNER \
(Name) 'J A mQ~s
(Address )So-me....---
j) 7JA/7 (
(Phone51Sd-L.Lg()- ~C) 7 2
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
o Deck
DPorch
~e-Roofing
~e-Siding
OUtility Connection
o Misc.
o Lower Level Finish
ched-
o Fireplace
o Addition
OAlteration
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 a that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
en upon the property to r rm ee d inspections.
~
x
Signature
Contractor's License No.
r-- -
~-C).D-O ~
Date
Permit Fee
Plan Check Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
Permit Valuation
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
#
#
This Application Becomes Your Building Permit When Approved
Building Official
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