HomeMy WebLinkAboutBuilding 07-0631
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
.? 11 (. "7
(Please
ADDRESS
White
Pink
Yellow
File
City
Applicant
I PERMIT NO.{? '7_ ()t.73 / I
52h2-
r-;e::;.J';- POI A/-;- U /C
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
<
(Phone) bIZ 2(/5 st;qt,
(Phone) b (;2 t..( QS I Cf ( "3
-- -'J /(
(Address)
TYPE OF WORK 0 New Construction oDeck oPorch ORe-Roofing
oAddition oAlteration o Utility ConnectIon
I)e-Siding oLower Level Finish 0 Fireplace
CODE: OLR.C. OLB.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/VALUE $
(excluding land)
I hereby certily that I have hlrmshed mlilIma110n on thIS applicatIOn whIch IS to the best of my knowledge true and correct. I also ccrllly that I am the owner ()) authollzed agl'l1t li,r the
above mentlllned plllpelty and t . .1)1 COnstlUctUJl1 wIll conlorm to all eXlstmg state and local laws and wIll plOceed m accOldance WIth submItted plans j .1m dWale that the blllldmg
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nature Contractor's License No. D~te
Permit Valuation
Permit Fee
$
$
$
$
$
$
I $
$
Park Support Fee
SAC
#
#
$
$
$
$
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechal11cal Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Date
Builder's Deposit
Other
#
#
Water Tower Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
TOTAL DUE
.n (>
This Application Becomes Your Building Permit When Approved
Buildlllg Urticlal
ThIS IS to certIfy th"t the request Il1 the abuve "ppllcatllln and accomp"nYll1g documents is Il1 accordance with the CIty Zuning Ordmance and may proceed as requested. TIllS document
when signed by the City Planner constItutes a temporary CertU,eate of Zonll1g cumpIrancc and alluws construction to commence BetcHe occulMncy, a Cntlflcate of Occupancy must be
issucd
Planning Director
Special Conditions" if any
Date
24 hour notice for all inspections (9S2) 447-9RSO, fax (9S2) 447-424S
4646 Dakota Street Prior Lake, MN 55372