HomeMy WebLinkAboutBuilding 07-0864
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
n at bottom)
Date Rec' d
I White
Pink
Yellow
'1// D! 07
I PERMIT NO. 07- O~ C"t..{J
File
City
Applicant
C~. Sf
ZONING (office lIse)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
---"''\0{ r h It So V\
01 (\ t Ct- S ~
(Phone)
(Address)
I --1SrJ
i BUILDER. _ ,
I (Cnmp,nyName) , .euSty ~.. COQ~. h
I (Cnnt'" N,me) , M \ Ice , ~ " s.
I (Address) 1lP~ 0 WOO. -
:PJ1C,
~1 a -3~'f:J...
q~)..-LI{J. ~1{ f
TYPE OF WORK 0 New Construction OOeck OPorch e-Rooting ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration o Utility ConnectIon
CODE: ~.R.C. OI.B.C. o Misc.
Type of onstmction: I II III IV V A B PROJECT COST /V ALUE $ -'lO{){).OO
Occupancy Group: A B E F H I M R S U
Division: ~ 2 3 4 5 (excluding land)
I hereby certify that I have turnlshed Information on this application which IS to the hest of my knowledge true and COlTcct. I also certify that I am the owner or autllOnzcd agent for the
<lbllve-mentlOncd property and that all constructIon will conform to all existmg state and lncallaws and will proceed in accordance with submitted plans I am aware that the huild1l1g
official can revoke tl S P rmlt for Just cause Furthermore, I hereby agree that the Clty official or a deSIgnee may enter upon the prnpel1y to pert()rm needed 1I1Spectlons
X , "/',,., '^_~_p),Z- ~~__ ,:)U I;;' 3/7~ q l,oliC]
Signature I Contractor's License No. Date
II
Permit Valuation F''Z-SO 0 . t) n
Permit Fee $ 7L(, 7 5
Plan Check Fee $ -
State Surcharge $ I ' 2--S"
I Penalty $
I
I Plumbing Permit Fcc $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
This Application Becomes Your Building Permit When Approved
I~~
t lllllldlllg Urtlcial
"foro 7
Dat~
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # $
Builder's Deposit I $
Other $
TOTAL DUE $ 7~. D-e
I Paid ~' ,Do
Date -~IO '07
,
po( Ii ~ ~(D(o
Receipt No. 5,,/ bz~
By ~
.,....
ThiS IS to certIfy that the requL'st 111 the above applicatJOn and accompanY1l1g documents is III accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner constItutes a temporary CertIficate of ZOlllng compliance and allows constructIon to commence Before occupancy, i1 Certlticatc of Occupancy must he
i."iSIIcd
Planning Direclor
Special Conditions, if any
Dale
24 hOllr notice for all inspcctiolls (952) 447-91150, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372