HomeMy WebLinkAboutBuilding 06-1081
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/2.7.. Ob
File
City
Applicant
I PERMIT NO. tf _ 108/
I White
Pink
Yellow
(Please
ADDRESS
5170
/ SZ) 12-(
~
ZONING (office use)
LEGAL DESCRIPTION (ollice use only)
LOT
BLOCK
ADDITION
PID2..J~ 2--?f-: ()O /_ ()
OWNER
(Name)
(Phone)
(Address)
CC,~a-9~7 'blob
ftAu.. ~-s-4 ;Z b
BUILDER
(Company Name)
(Contact Name)
(Address)
Jol.-" ~~ I ~~
~ ~er-
(D~4 WJ ~7-n+ ~-\- -* I'D4-
(Phone)
st b~J ~h~
TYPE OF WORK 0 New Construction ODeck OPorch -Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditJOn OAlteration o Utility Conne tJOn
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I havc furnIShed Information on this applicatIOn which IS to the best of my knowledge true and correct. I also certify that I am the owner ()J "uthorJzed "gent Illl' the
dbovc-mentwned property and that "II CllnstructlOn will conform to all eXIstIng state and local laws and will proceed rn accordance with submitted plans I am aware that the buIldrng
offiCial can 0 'l' tlm perm 1'0". ust cause Furthermore, I hereby agree that the CIty official or a deSignee may enter upon the propeI1y to perllJrm needed rnspectHHlS.
Contractor's License No,
Permit Valuation
Permit Fee
Park Support Fee
SAC
$
$
$
$
$
$
I $
$
TOTAL DUE
Plan Check Fee
Water Meter Size 5/8"; I",
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Pressure Reducer
Sewer IWater Connection Fee
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Y OUT Building Permit When Approved
lluildlllg UrtiClal
Date
#
#
#
#
1~-7 -cnb
Date
$
$
$
$
$
$
i $
$
$
ThIS IS to certify that the request 111 the above applicatlOn and accompanYll1g documents IS 111 accordance with the City Zoning Ordinance and may proceed as requested. TIllS document
when signcd by the City Planner Cllnst!tutes a temporary Certiticate of Zonrng compliance and allows construction to commence Before occupancy, a CertIficate of Occupancy must be
i."islIt'd
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any