HomeMy WebLinkAboutBuilding 06-0915
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
16 "II, f)"
(Please
ADDRESS
5449
/I'M (/ t,6/1/67J ()
White
Pink
Yellow
File
City
Applicant
PERMIT NO.
0' . 0 q IS-
ZONING (officc use)
,f) IL '
LEGAL DESCRIPTION (office use only)
ZIS-, 07 ( 0
PID z..r: 1):18, 6Je,.. ~
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name) ):~.._ 'p...~L oJ- ') J;,."....L.r .
(Contact Name) ~;"7 S,:......
(Address) 1/ '/ t"c,
(Phone)
(Phone)
4)'";; ") -~ ~ s-- 57S-'
-
t,/;l.-J' ~-~~S/
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility Connection
e-Siding OLower Level Finish 0 Fireplace
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V
HIM
2 3 4
A
R
5
o Misc.
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certily that 1 have hlrDlshed mfC1rmatlOn on this applicatIOn which is to the best of my knowledgc true and correct. I also certifY that I am the owoer or authonzed agent for the
above-mentIoned property and that all construction WIll conform to all existmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
"f!iClal can re~permll for Just cause Furth~ee that the City offIcial or a deSignee may enter upon the property to perform needed mspectlons
X /~~~ /~-/l-(Jl
Signature Contractor's License No. Date
Permit Valuation d) .r rn>" f'1.)
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Yout[ Building Permit When Approved
13ulldll1~ Official
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ ~.()O
/1 I
ThIS IS to cerllfY that the request in the above apphcallon and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested ThiS d"cument
when signed by the CIty Planner Cllnslltutes a temporary Certitlcate of Zonmg compliance and allows construction to commence. Before occupancy, a Certlticate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372