HomeMy WebLinkAboutBuilding 07-0598
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pin~
1 Yellow
I PERMIT NO.
()7.oSreJ
File
City
Applicant
Ndtcm1!\,/{fD 0 /f-tJ/t:D~-
" ,
Date Rec' d
7 Iv, 07
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Address)
(Phone)
BUILDER
(Company Name) ,-:::';,").J PI rU if .::>
(Contact Name) N r':tol/1 t. <; H
(Address) J 0" 'L
J.\c,.p... E ( ", i: I 'I , (1'') ...s
U ?PP\L-
;J ~L.
(Phone)
(Phone)
,&,3 - '-f c, 8-1535""
TYPE OF WORK 0 New Construction ODeck OPorch
OAdclition OAlteration OUtility Conne
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
L1...('" r1-"\ ,-,
ORe-Siding OLower Level Finish 0 Fireplace
o Mise.
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I have nlrOlshcd mformatIOn on this applicatIOn which 1$ to the best of my knowledge true and cOITect. I also certify that I am the owner or authorIzed agent for the
above-mentioned property and that all Clmslructllln Will conform tll all eXlstrng stale and lllcallaws and WIll proceed in accordance with submitted plans I am aware that the bUlldrng
()tflCial can revoke thIS permit for Just cause Furthermore, I hereby agree that the Clty official or it desIgnee may enter upon the propcny to perform needed mspectlOns
x
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
! Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
I Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildlllg UIliclal
Date
Contractor's License No.
Od. Date
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
--
~J~4-<f-
This IS to ct'ftity that the request 111 the above application and accompanYlllg documents is m accordance wIth the City Zoning Ordinance and may proceed ilS requested TillS document
\vhcn signed by the CIty Planner cor:.stItutes a temporary Certificate uf Zonmg compliance and allows constructIOn to commence Before occupancy, a Certificate lJfOccupancy mllst be
issllcd
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE
Planning Director
Date
24 hour notice for all inspections (952) ....7-9850. fax (952) ....7-..2..5
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any