HomeMy WebLinkAboutBuilding 02-0121
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
30UN7l( .51.
5500
LEGAL DESCRIPTION (office use only)
2 -- 771;;02-
{.
~i~i~e ~:~y I PERMIT NO. 07 ""01'7/
Yellow Applicant , 1./ V
~6
ZQ.JilIN G (office use)
,,/..t::4
'"<<:>
/ - 7l:!
CP~
PID 25-1
- #-4-- ()
LOT iSBLOCK:5 ADDITION ,5',ea;)::-Jtll~ rtlC--t-J
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
~L~ ~F PPVO/L
~ UdN.t~
L/te-C
(Phone)
(Phone)
qLl1
9P9/
TYPE OF WORK
o New Construction
ODeck
OPorch
OUtility Connection
DLower Level Finish
o Fireplace
t1I elL, f/lJ VJ ;:;.; .# S- PROJECT COST IV ALUE (excluding land) $
DAddition
o Mise.
e-Roofing
ORe-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
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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter u the property to perform needed inspections.
x
Permit Valuation Z/500- () 0
Permit Fee $ 7'-1. 7.s-
Plan Check Fee $ ~
State Surcharge $ I. 25
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.
01.-10 - Oa.-
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $ ,/ "-
Other WrtIVel) ~'lt/.'7~ /
TOTAL DUE $ - /.~'
Paid
Date
~ !~2-
I ~;c14
4lrXJ ~
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