HomeMy WebLinkAboutBuilding 08-0031
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
f-O~
/V7f;otr~7
Date Rec' d
/. ~~ . ob
I White
Pink
Yellow
I PERMIT NO. 68 . 003./1
File
City
Applicant
/?to c~ ~
ZONING (ollice use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
c'~JM~n {;,IlS41. :rnc.
~'1 p~~ '
145~;)- wi'las ~
(Phone)
(Phone)
hlJ-- ;; t.f:J- ~~'i 77
S-S:3 7 d--
TYPE OF WORK D New Construction DDeck DPorch e-Roofing
DAdditlOn DAlteration DUtility Connec IOn
DLower Level Finish D Fireplace
CODE: DI.R.c. DI.B.c. D Mise.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certity that I have hlrmsheG Information on this apphcal10n which IS to the best of my knowledge true and correct. I also certIfy that I am the Dwner or authonzed agent for the
abovc-mcntHlned prDperty and that all CllnstructlOn Will cont(lrm to all eXIStIng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildIng
~liClal can revoke th p "mil for Just c 'Furthermore, I hereby agree that the City official Dr a deSignee may enter upon the propel1y tD pert(Jrm nee;'~ 7~:nO(
Contractor's License No Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
j Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $ I
Gas Fireplace Permit Fee =:j$
This Application Becomes Your Building Permit When Approved
llulldlllg UfIiclal
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
ThIS IS to certify that the requL'st In the above applicatIon and accompanYIng documents is in accordance with the City Zoning Ordinance and may proceed as requested Tlus document
when Slgn",1 by the Clly Planner constitutes a temporary Cernficate of Zonmg compliance and allows constructIOn to commence Befme occupancy, a Cernficate of Occupancy must be
issucd
Planning Director
Special Conditions, if any
Date
24 honr notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372