HomeMy WebLinkAboutBuilding 07-0501
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
n at bottom)
/tpz&8
09C;LE ~-aC
Date Rec' d
h~ /8. ill
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 07.050/
/fV~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
PIDZS-_ 001.0/8.0
OWNER
(Name)
Q-y<75..5"
~ ~ ~ .wv---d
(Address)
(Phone)
6/;'. '. 'fJO~?t53
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdclitIon OAlteration OUtility ConnectIon
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
II
F
I
V
M
4
A
R
5
III
H
2
IV
I
3
I
E
o Mise
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
8) 006-
I hereby certily that I have furmshed mformatHln on this apphcation which IS to the best of my knowledge true and correct. I also certify that I am the owner or authollzed agent lor the
aboVt'-mentHlned pmpcrty and that all construcllon will conform to all eXlstmg state and local laws and will pmceed in accordance wrth submllted plans I am aware that the buildmg
olflcial can revoke th rmll Il)r Just cause urthermore, I hereby agree that the CIty official or a designee may enter upon the property to perf()rm needed rnspect"'os
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
~echanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Permit When Approved
Buildll1g UIli(ial
Date
Contractor's License No.
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
#
#
#
#
6'- /? 0 2--
Date
$
$
$
$
$
$
$
$
$ 7&,00
(j Z.J
ThiS IS to certify thilt the [('quest in the above applicatIOn and accompanymg documents is 10 Jccordance with the City Zoning Ordinance and may proceed as requested ThiS dllClImcnt
when signed by the CIty Planner constttutcs it temporalY Certificate of Zomng compliance and allows construction to commence Before occupancy. a Certlfi.cate of Occupancy must be
isslIcd
Planning Director
Special Conditions, if any
Date
24 hOllr notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372