HomeMy WebLinkAboutBuilding 07-0019
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
n at bottom)
Date Rec' d
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 01- I Cj I
ZONING (office lIse)
-VioD
~ L /1 )
J/iL .f -4~ CL
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDJ~--OOI-OL)5-G
OWNER
(Name)
(YJ oe J.~ r
(Phone)
~ , a - 'I L 0 - 6-7 9 S-
Apryl
(Address)
BUILDER
(Company Name)
(Contact Name)
--;-n((\Cl~J L' A-II c' '-I
',- IS ,f
---1", ,€-', . F- I ':::. i-
(Address)
57/0
cSt
~- '-1."->
"....)~, -
~'-/
Ro<'~/~,)
{.~S!- -j 1"7 - ~/.) 'I
tV
s+.
'-ou
TYPE OF WORK 0 New Construction ODeck OPorch ~'Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration OUtility Connec~
CODE: OLR.C. OLB.C. o Misc.
Type of Constmction: I II III IV V A B PROJECT COST IV ALUE $ -:;( .5 co. ----
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5 (excluding land)
Il1ereby eertity that I have hlfntsl1ed lI1formatlon on this applicatIOn which IS to the best of my knowledge true and eOITect. I also certify that I am the owner or authollzed agent tlJr the
above-mentwned property and that all CtJnstructlU!1 w1l1 conform to allcxistmg state and local laws and will proceed in accordance with submItted plans I am aware that the buildIng
oftiClal can revoke thl. I'm - I' Just ause Furthermore, I hereby agree that the City official or a deSignee may enter upon the propeny to pertlltm needed mspectwns
x
Permit Valuation ~6C(), OK>
Permit Fee $ 7 i/ 7 t)
Plan Check Fee $ / '.:7 !;;
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
Mechalllcal Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Huildlllg Ufficlal
Date
<905<110 X Co
Contractor's License No
/-- 0"'07
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 $ ?JG, -
7-~ : -Q~
i ~~"iPt ~.).;; 7~
Paid
Date
ThIS IS to certify that the request 10 the above applicatll1I1 and accompanYlllg documents is 111 accordance with the City Zoning Ordinance and may proceed as requested TillS document
when signed hy the City Plannn constItutes a temporary Certificate of Zoning complIance and allows constructIon to commence. Before occupancy, a Certlfi.cate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) .t.t7-91l50, fax (952) .t.t7-.t245
4646 Dakota Street Prior Lake, MN 55372