HomeMy WebLinkAboutBuilding 08-0022
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/. /1. ob
File
City
Applicant
I PERMIT NO. 0 ~ . 00 z,z.}
] White
Pink
] Yellow
(Please
ADDRESS
/4/7h
SHo~
NE:
LANe
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT l..OsLOCK 1-- ADDITION 5"''';.0 /JT. 4TH
PID 25. 2/5, Db 1-; C
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name) s- V r
/ 0 :5 5-
(Address)
BE-ISSEL- W/Nf)(jW
LA /Vl t: 'f tyL
011 ]LD fl-L- C
\--1/ (j T
(Phone) fa j (
(Phone)
, ")
,')/ ' (' rvc
t
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAdditlOn OAlteration o Utility ConnectIon
Re-Siding
OLower Level FinIsh
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
o Mise
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)
$
JjTj
eflS-
5 S- I LJ
o Fireplace
I hereby certily that I have hnnIshed mlillmatio,fL\In thIs apphcatlOn whIch IS to the best of my knowledge true and correct, I also certify that I am the owner or authorized agent li)r the
abllVc.mentllJned, ,property an, d thaI a,1l constalcllyt, will conform 10 all eXlstmg state and local laws and will p,roceed in accordance with submllted plans I am aW',lre that the bUlldmg
offiCial ca feyokeJJ,11s permit for JUst0lusc,~hcrmorc, I hereby agree that the CIty offiCIal or it desIgnee may enter upon the prOpeJ1y to perform needed inSpectIOns
X "~ '. : ,,/ / C"-- ....J ro J-I ):l () (- j 7 - () i
Contractor's License No, Date
Permit Valuation Z SOO.oO
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
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 Application Becomes Your Building Permit When Approved
Building UfflClal
Dale
$
$
$
$
$
$
$
$
$
ThiS IS to certify that the request In the above applicatloJ1 and accompanymg documents is In accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the CIty Planner constlLitcs a temporary Certificate of Zonmg complIance and allows constructIon to commence, Before occupancy, a CertIficate of Occupancy must be
i.ssued
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