HomeMy WebLinkAboutBuilding 07-0137
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
3.2-0_D7
LA liE
?oA
S?tz,',J~
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 01. 01:57
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Phone)
Q"52 L.{47-704l
OWNER
(Name) 't5i'2Jc.c
{!. A 15Lfl iZD
PID 2.5 _ \33 _ h4-& - 0
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
OAddition OAlteration o Utility ConnectIon
CODE: OI.R.C. OI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV
I
3
V
M
4
A
R
5
o Mise.
B
S U
$
PROJECT COST /V ALUE
(excluding land)
I hereby certify that I have turOlshcd mformatlon on this application which IS to the best of my knowledge true and correct. I also eerury that I am the owner O}" authOrIzed agent for the
above-mentlllned property and that all constructIOn w1l1 eonttJrm to all eXlst1l1g state and local laws and Will proceed 111 accordance with submitted plans I am aware that the bulld1l1g
;liClal cad?~s~c:7'more. 1 hereby agree that the City official Dr a deSignee may enter upon the pmpeny to perform nee;~,;c~lI1s 20 _ (} "7
- Signature Contractor's License No. Date
Permit Valuation 2,S-0"0...-0\.)
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
! Plumbing Permit Fee $
~echanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Permit When Approved
lllllldll1~ Ulrlelul
Dute
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 $ 1~. 0 0
Paid
Date
'i(,.oo
- ~"()7
if' No -'>]' ZI ~
ThiS IS to ({,ftity th,lt the request In the ilbove applicatH)n and accompanYll1g documents IS In accordance With the City Zoning Ordinance and may pn)cecd as requested ThiS diKumcnt
when signed by the City Planner constItutes a tempDralY Cemficate of ZOlllng comphancl' and allows construction to commence Before occupancy, a CertIflclle of Occupancy must be
i,Sslled
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspectious (952) ~~7-9850, fax (952) ~~7-~2~5
4646 Dakota Street Prior Lake, MN 55372