HomeMy WebLinkAboutBuilding 06-1015
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1+
~ G-t, NE
Date Rec' d
/(,8rO"
White
Pink
Yellow
I PERMIT NO. {)(p . /0/51
File
City
Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT >< BLOCK ADDITION
PID 25. :JG,2... 008.0
(Phone)
(Phone) g l5-r,22t
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration OUtility Co nectlon
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A:S
Division:
III
H
2
IV V
I M
3 4
A
R
5
I
E
II
F
1
o Misc.
B
S U
$ J() i74B
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 true and correct. I also certify that I am the owner or authonzed agent t"r the
above-mentIOned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
official can revoke thIs Rermlt for Just cause Furthermor, I hereby agree that the CIty official or a deSIgnee may enter upon the propel1y to perform needed ms ectwns
X ~D J= }():so II (J7 Q(j)
Signature Contractor's License No Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
Buildlllg Ofticial
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7',0 ()
Paid
Date
!7ioro
rp, No
./
S-~'J8
This IS to certIfy that the request m the above application and accompanymg documents IS 10 accordance with the City Zoning Ordinance and may proceed as requested Tim document
when signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows construction 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) 447-98511. fax (952) 447-4245
] 6200 Eagle Creek Avenue Prior Lake, MN 55372