HomeMy WebLinkAboutBuilding 06-1011
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/1. 70ro
1 White
Pink
Yellow
File
City
Applicant
I PERMIT NO. ?Iof /
n at bottom)
ADDRESS
ZONING (office use)
/4-'u~8
~ /t!:4 0 Vb
~o cFt5 ~ '--'
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID z"r, z,8fe- 0/7,0
OWNER
(Name)
(Address) /
tA.-/O ~~ e--
'/f,.1/c{/~A1~(-> 7K.Y ~
(Phone) ~.52~)'-}5(bY
BUILDER
I (Company Name)
I (Contact Name)
I (Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck DPorch
OAddition OAlteration o Utility Conn
e-Roofing ORe-Siding DLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certifY that I have hlrmshed mformation on this application which IS to the best of my knowledge truc and correct. I also certify that I am the owner or authonzed agent for the
abow-mentlOned property and that all CllnstructlOn Will CllnfiJrm II eXlstmg state and local laws and will proceed m accordance with submitted plans I am aware that the btllldmg
ntlicial can revoke thiS pel '~hcrmorc, I e grec that the CIty official or a deSignee may enter upon the property to perform needed inSpectIOns
x
Contractor's License No.
Water Tower Fee
#
#
$
$
$
$
$
$
$
$
$
'1("OC
Gas Fireplace Permit Fee
$
$
$
$
$
$
I $
$
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; I",
Pressure Reducer
Sewer/Water Connection Fee
Sewer & Water Permit Fee
Builder's Deposit
Other
TOTAL DUE
lluildll1g Urticial
Date
This Application Becomes Your Building Permit When Approved
ThiS IS to certIfy that the request in the above applicatIOn and accompanymg documents is 111 accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constItutes a temporary Certificate of Zonmg Cllmphance and allows construCllon to commence. Before occupancy, a CertIficate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any