HomeMy WebLinkAboutBuilding 07-0437
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(p.f',07
I White
Pink
yellm....
File
City
Applicant
PERMIT NO'o1 043
:35/ tj
tf/lJJ j1/dtJO
-
u~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
PIDZ6./{O.oo5. 0
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration o Utility Conne
/....L d (Phone) c..a-"j9o- 58 >~
(Phone)
\1\ .IJ. S s..?s.
ORe-Siding OLower Level Finish 0 Fireplace
17wJ.r /f.,C/O Itl t1-
CODE: DI.R.c. DI.B.c. ~iSC.
Type of Constnlction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
I hereby certily that I have furmshed informatIOn on thIs applicatIon which IS to the best of my knowledge true and COlTect. I also certify that I am the owner or authollZed agent !(Jr the
above-mentIoned property and that ,III constructIon Will eontllrm to all eXlstmg state and local laws and will proceed In accordance with submitted plans I am aware that the buildmg
official can revoke this lermlt for Just calise F~~, I hereby agree that the CIty official or a deSIgnee may enter upon the propel1y to pert(1fm needed tnSpcctWIlS
X ~-~ '-- ~- $1'-0>
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechamcal Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $ i
This Application Becomes Your Building Permit When Approved
lluildllll! Urtleial
Date
Contractor's License No. Date
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 IS to certify that the request in the above applicatlOn and accompanymg documents IS In accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Plilllt1Cf constitutes a temporary Certificate of Zonmg compliance and allows construction to commence Before occupancy, ,I Certificate of Occupancy must be
i.sslled
Planning Director
Special Conditions, if any
Date
24 hour notice for all iuspeetions (952) 447-91150, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372