HomeMy WebLinkAboutBuilding 06-0143
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
:3 _ 7. (!(o
I White
Pink
J Yellow
File
City
Applicant
I PERMIT NO. 0&,1 (j f 4- 31
(PI,~ "" m pri.' ~d :. bottom'
ADDRESS
5S 0
Co~N t..-" d:>.;> {J
ZONING (office usc)
G5
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID i?,5-. Z, 1'7. 0 () i. 2-
OWNER /'t
(Name) \,;.oo~l~
(Phone)
AtvQ6D-$ 0 ~
(Address)
s~!:.
..s~
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility Connection
ORe-Siding OLower Level Finish 0 Fireplace
CODE: DI.R.c. il5lt.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
~MiSC.
~~ ~~\Sl* ~~
PROJECTCOST/VALUE $ 5~. ,-
(excluding land)
I II III
E ~~
IV
I
3
V
M
4
A B
R@U
5
I hereby certify that I have furl1lshed mformation on this application which is to the best of my knowledgc true and correct. I also certIfy that I am the owner or authorIzed agent for the
ab<Jve-mentlOned property and that all construction will conform to all exisnng state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
<Jfficial can revoke t ermll for Just cause ore, I hereby agree that the CIty official or a deSignee may enter upon the propeny to perform needed mspectI<Jns
X
Contractor's License No.
Permit Valuation Park Support Fee
Permit Fee $ SAC
Plan Check Fee $ Water Meter Size 5/8"; I";
State Surcharge $ Pressure Reducer
Penalty $ Sewer/Water Connection Fee
Plumbing Permit Fee $ Water Tower Fee
Mechanical Permit Fee $ Builder's Deposit
Sewer & Water Permit Fee I $ Other
$ TOTAL DUE
#
#
#
#
o ~- '0 · 0 <P
Date
$
$
$
$
$
$
$
$
$
ThlS 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. TillS document
when signed by the Cay Planner conslltutes a temporary Certificate of Zonmg comphance and allows construction to commence Before occupancy. a CertIficate "f Occupancy must be
issued
Planning Director
Date
24 hour notiee for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any