HomeMy WebLinkAboutBuilding 07-0247
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
tf-. VJ, (/ 7
(Please
ADDRESS
jbb97
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j1f//V'/1
White
Pink
Yellow
File
City
Applicant
PERMIT NO. 07. 0 ~4'1
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
OWNER
(Name)
5to#
L(J n <2-
(Phone)
9'5.2 - '-// ~- 740~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Conne
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
III
H
2
IV V
I M
3 4
A
R
5
I
E
II
F
1
(Phone)
(Phone)
ORe-Siding OLower Level Finish 0 Fireplace
o Misc.
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have hlrmshed mformation on this apphcatlon which IS to the best of my knowledge true and wITecr. I also certify that I am the owner or authOrized agent felf the
abllve-mentlllned property and that all construction wIll contllrm to all eXlstlOg state and local laws and Will proceed in accordance with submitted plans I am aware that thc buildmg
official can revo ' hiS pelmlt f()l)J;~;t cause FUltheIffiOlc, I hCleby agree that the CIty otflClal or a deslgnce may enter upon the pIopeJ1y to pCltnrm needed lI1SpectHHls
X ~/~ ~--;:;o <<~(>7
~~re Contractor's LICense No Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Y OUT Building Permit When Approved
l3uildlllg Onlclal
Date
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 $
ThiS IS to certify that the request in the above applicJtlun and accompanYIng documents is 111 accordance with thc City Zoning Ordinance and may proceed as requested ThlS document
when SIgned by the City Planner constItutes a temporalY Cerllficate of Zonrng comphance and allows constructllln to commence Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) ~~7-9850. fax (952) ~~7-~2~5
4646 Dakota Street Prior Lake, MN 55372