HomeMy WebLinkAboutBuilding 07-0427
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE. .
AND UTILITY CONNECTION PERMIT
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
Date Rec' d
(; . I. 07
I. White File I PERMIT NO I
2. Pink City . 01 . 04-?1
] Ydlow Applioo.. . ~ t .
I ZONlNGc__> I
PID Z~. /3 t. 6 I O. 0
.J- LCttJr Ie"
(phone)
q 5) .' YO':)' C)Y:Q.
OWNER ~
(Name) ~ erry
(Address)
=:-Name) ~JJn liv"ar/ tncrha-(/}Q/J
(Contact Name) 64/ ((1
(Address) 6&'1/ /1' emfJr /a./ /fro /Y. 7~ ''lAJa.la.
Cc~l~
(phone) uGI.~:J; 9. "/3 x)
(phone)
~ 5"StJ 4' ~
TYPE OF WORK O\New Construction ODed: OPorch 'i;am:.Roofing ORe.Siding DLower Level Finish 0 Fireplace
OAddition ~teration OUtility Connection 0 Misc.
CODE: OI.R.C. OI.B.C. PROJECTCOST/VALUE s~ 59,80
Type of Construction: I IT m IV V A B (excluding land)
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
I hereby certify that I have furnished information on this application which ilto the bet of my knOWledge lnIe and corm:t. I also certify that I am the Own~T <lI" authoriu'Ci asent for the
above-menboned JlI'OPMY and that aU constrUction will conform to aU existina stale and local laws and will proceed in accordance: with submilled plans. I am aware that thc buildina
;1ciaJ can this p "!for just causc. F~rthmnore I hereby agree that the city o~:- ;fin;; ;e;; the property to pmorm 3i3ilcr:t-
Signature Contractor's License No. Dati:
Permit Valuation
Permit Fee $
Plan Check Fee S
State Surcharge S
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Pennit Fee $
Gas Fireplace Permit Fee S
This Application Becomes Your Buildlnl Permit When Apprond
Buildin2 Official
Dale
Park Support Fee # S
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # S
Water Tower Fee # S
Builder's Deposit S
Other $
TOTAL DUE S '14-.00
I Paid
Date
-:/(-,
I~'
...../
.!:.-? /}i:Y1
/
,
I..?
1J1
,
ThIS IS to certify thaI the request in the above application and ac:companyina documents iI in accordance with the City Zonina Ordinance and may prOCttd as requ~'Stcd, This document
when siancd by the City Planner constitutes a temporl\fY Certificatc of Zoning compliance and allows conslnlClion to commence, Before occupancy, a C~'t'tificatc of Occupancy must be
issued
Planning Diredor
Date Special Coaditiona, if any
24 hour notice for all Inspections (~2) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372