HomeMy WebLinkAboutBuilding 07-0312
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
l(a
VW~towl' eJ)
Date Rec' d
5. 9. 07
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 07, 03/ Z- I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZ-S. q 02,. octl. 0
OWNER
(Name)
(Address)
(Phone)
BUILDER
(Company Name)
(Contact Name)
c..oE~ .s E"RV \ c.€.S
L~~ (~
~~
Cj.-<>~~-rii. ~+
5~
(Address)
~Jf.e
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Conn
CODE: OI.R.C. OI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
V
M
4
A
R
5
II
F
I
III IV
H I
2 3
I
E
(Phone)
(Phone)
Cf-s L Z'7L.. 4- 'fS€>
e-Roofing
Ion
ORe-Siding
OLower Level FinIsh
o FIreplace
$
o Mise
B
S
U
PROJECT COST IV ALUE
(excluding land)
I hereby eCltity that I have turmshed mformatHln on this applicatIOn which IS to the best of my knowledge true and correct I also certify that I am the owner or authollzed agent t"r the
abnvl'~ml'ntlOn property and that all ClmstructlOll will conform to all eXlst10g state and local laws and will proceed 10 accordancc with submltted plans_ 1 am awarc that thc buildmg
official CJn rcvo 11S pcrmtt for Just cause Furthermore, I hereby agree that the CIty official or a deslgnee may enter upon the propel1y to perform needed mspectHlIls
Signature
$
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
llulldlllg Ufticial
Date
t...<;"7 '2 os-LJ ~
Contractor's License No.
Park Support Fee
#
#
S- /1' el
Date
$
$
$
$
$
$
$
$
Thls is to certlty that the request 111 the above applicatlOn and accompanYll1g documents is 111 accordance with the City Zoning Ordinance and may procecd ilS requested Thls documcnt
when signed by the CIty Planner Cllnstltutes a temporary Certlticate of Zonmg compliance and allows construction to commence Before occupancy, a Certlticate of Occupancy must be
issucd
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
Planning Director
Special Conditions. if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372