HomeMy WebLinkAboutBuilding 07-0972
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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n at bottom)
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Date Rec' d
I White
Pink
Yellmv
I PERMIT NO. 7 :~z.. I
File
lily
Applicant
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ZONING (oillce use)
I ~ /C;f
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
t--
OWNER
(Name)
~~
t.{ l{ to U, 4..L~ ~
l"'\
(Address)
'I i BUILDER ?
I (cOmpanYName)~':;"~ ~
I (Contact Name) O~ '1
I (Address) l1. ,"'l)"'" D
(Phone)
~,?- '1t/- ?S'7
?~" y bl.e
(Phone)
(Phone) 1'S"'A. - V3J.-- q 7V.....,
TYPE OF WORK D New Construction DDeck DPorch ~Re-Roofing ~e-Siding DLower Level Finish D Fireplace
DAdclitlOn DAlteration o Utility COnneCtiOn
CODE: DI.R.C. DI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
D Misc.
A
R
5
B
S
PROJECT COST IV ALUE
(excluding land)
$
?/~CO, OC-
t
U
I hereby certIfy that I have furmshed mf()rmatlOn on thiS applicatIOn which IS 10 the best of my knowledge true and currec! I also certIfy that I am the owner <lI authollzed agent tlJr the
abllvc-mcntlOncd property and that all cnnstrtlctlOn will conform to allexistmg state and local laws and will proceed in accordance with submItted plans_ I am aware that the buildmg
official can revoke tillS permn for Just cause Furthermore, I hereby agree that the cny official or a deSIgnee may enter upon the propelty to pertiJrm Ileeded mspectHllls
X ~~__9"'_-c..____ 2.v/O'l'-t.!Jf /4-9-07
Signature Contractor's License No. Date
Permit Valuation "2
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
! Plumbing Permit Fee $
Mechal11cal Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
s Your Building Permit When Approved
---
,ok 1-9
,f:j
,
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7{,~
Paid
Date ,,J q I t>7
; ,
Recei~No.~Cf81 Sf
By #J
ThIS IS to certlty that the request 10 tl~,e above applicatml1 and accnmpanYlIlg documents IS 111 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when Signed by the Cny Planner ClInstllutes a temporary Certificate uf Zonmg compliance and allows constructIOn to commence Before occupancy, a Certificate of Occupancy must be
isslled
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372