HomeMy WebLinkAboutBuilding 07-0632
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7_ /707
ADDRESS
~qD~
SprlJ) ~ L {l t.
f2d
I. White File I PERMIT NO I
2 Pink City . 0'1... 0/3 ?
3. Yellow Applicant , ' liJ. L- ,
sw
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID.;.Z:::'::>. 1.3.3. ()S(P~ 0
OWNER
(N ame)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
THD At-Home Services, Inc. d/b/a
The Home Depot At-Home Services
3200 Cobb Galleria-Suite 200
Atlanta, GA 30339
Lic# 20268257 Ph. 763/542-8826
(Phone) qS;I / 4 47 . 411 L.J
LJ
(Phone) q5;1! '34 'S . bOY 7
(Phone) Joel I {j} EJ t/"r JDN ~
TYPE OF WORK
o New Construction
~ding
DLower Level Finish
o Misc.
DDeck
OPorch
ORe-Roofing
o Fireplace
DAddition
OAlteration
OUtility Connection
PROJECT COST IV ALUE (excluding land) $
/71,'-lB
I hereby certifY that I have furnished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or
authorized agent for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans, I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to erfi rm needed inspections.
x~
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Building Official
Date
;) 0;;' l, & ') "7
7IJ~/DI
Date
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7C..,. 00
Receifo. UZ34-
By... _'
{I
~..O{:
/1 o}
Paid
Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372