HomeMy WebLinkAboutBuilding 06-0956
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Date Rec' d
I. White File
2. Piok City
) Y oIlow Applico..
I PERMlTNO. 0&. OCJ5~ I
I I ZONING,__, I
1~~'~WApM~
I ADDRESS .
I~ 0 [e/d NL. w60d Gf,
NE-
LEGAL DESCRIPTION (offICe use only)
LOT
BLOCK
ADDITION
PID 2.). Z.I4-. 0"30. l>
(Address)
AJ'ltJ
5
'AI,_IL'. S ~
, Db s"'k
(Phone)
q~ - L/ 4~-- 3tsc(
OWNER /
(Name) ",I\/\. 1-
BUlLDER~ l/.?
(Company Name) ~t Lc:; s
(Contact Name) ~~~,.J J
(Address) '465'0 k.;)'t
W'lva~-+- $~Jl:) G, (Phone) Cf{;z-gq, -'S~oO
(Phone)
I /VW .5~ I ?..- <(
TYPE OF WORK 0 New Construction DDeck DPorch DRe-Roofinc
o Addition OAlteration DUtility Connection 0 Misc.
-Sidina OLower Level Fimsh 0 Fireplace
CODE: OJ.R..C. OI.B.C.
Type of CODStIUction: I
Ocaapancy Group: A B E
DiTision:
n mIVVAB
F HI MR.SU
I 2 3 4 5
PROJECT COST /V ALUE S 6; ~o{)
(exdwlin, land)
I Mreby certify thllll hlI~ furnished inforntlltion on this lIpplicalion which is to the best of my knowlc:dle lnIe and torm:l. I allo certify thllll am the owner or authorlZcd lIl1Cnt for lhe
lIbove. n t lIiI ronslnlclion will ronform to lIiI existilllltlllC and local laws and will proceed in accordance with submitted plans. I am aWllre thlIt the buildin,
ufflCia can .us causc. Furthermore, I hereby IlPft thllt the city officilllor a dcsi&n<< may enter upon the proprny 10 pnfOrm needed Inspections.
~ 2006C>'-/2 r ~O/)fl~()b
Contractor's License No. f ate
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Pennit Fee
Mechanical Pennit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
s
s
s
s
s
s
s
s
Park Support Fee
SAC
##
$
S
$
$
S
S
$
S
$
tif":' No !fJ s;1'fJ
#
##
Water Meter SizeS/8";I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
##
This Application Becomes Your Buildlna Permit When Approye.
I ~~~ ;~~;J.(J(o
Building Ollicinl
Dale
TIus IS to certify thllt the lI!qucst in the abo~ application and accompany in, documents is in lIccordll(occ with the City Zonin, Ordinance and rrIlIY proceed as rcquL'Stcd. This duculllt:nt
when silncd by the City Planner constitutes lItemporary Certificate of Zooin. compliancr and allows conslnlCtion to commencc. Before o<<upancy, a CertifICate of Occupancy must be
issued
Planning Director
Date Spec:iaI Conditiona. if my
24 hour notice for .lIlns~ctlons (~2'447-98~, fax (~2) 447-424!1
16200 Ealle Creek Avenue Prior Lake, MN 55372