HomeMy WebLinkAboutBuilding 07-0161
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
OT
BLOCK
ADDITION
PID
OWNER
(Name)
iVk.CbeU)~ AI
k \l 0 '" ~ Ao <.
, .
(Address)
Date Rec' d
"3(2-&1 107
I White
Pink
Yellow
I PERMIT NO.
File
Cily
Applicant
lJ7-01fol
ZONING (office use)
~~.
(Phone)
S~ .
BUILDER
(Company Name)
(Contact Name)
(Address)
~ V\'\~
A~
f:t~~
(Phone) '1~ - iJ..J.j7- ~i1
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ~Re-Roofing
OAddition OAlteration OUtility ConnectIOn
CODE: oo;.R.C. DI.B.c.
Type of ~stmction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
ORe-Siding OLower Level Finish
o Fireplace
o Mise.
PROJECT COST IV ALUE $
(excluding land)
I hereby certity that I have hlrmshed mformation on this ar. lication which IS III the best of my knowledge true and mITec!. I also certify that I am the owner or authollze,! agent tnr the
.lbovc-mcntwncd perty and that .111 C1?imstl tlon WIll form III all eXlstmg state and local laws and will proceed in accordance with submitted plans I am "wa. Ie that the buildmg
Ilfflclal can rcv.o IS permit for Just CillL' .l' hermo > I hereby agree that the cay official or a deSIgnee may enter upon the propel1y to pcrt()rm needed mspcctHlIls
- ~- ~~-()7
Signature Contractor's License No. Date
Permit Valuation ?If. 75
Permit Fee $ -
Plan Check Fee $ 1.2-~
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
~echanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
This Application Becomes Your Building Permit When Approved
~~
lluildlllg UfIicial
-S/'Z..tD/o7
. Dal'e
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fec # $
,
\Vater Tower Fee # $
Builder's Deposit i $
Other $
TOTAL DUE $ 7 to, 0'0
~b.OO
Date ('-<0/0 7
I ~~cei~o-5~ZZ-3
To
ThIS 1S to certify that the request 1I1 the above applicatllln and accompanYlllg documents IS 1I1 accordance wah the City Zoning Ordinance and may proceed as requested ThlS document
when signed by the CIty Planner const1tutes a temporary Certificate uf Zonmg compliance and allows construction to commence Before occupancy, ;l Ccrtlticilte ()f Occupancy must be
JSSUL'd
Planning Director
Special Conditions, if any
Date
24 hOllr noticc for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372