HomeMy WebLinkAboutBuilding 06-0893
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
CekwoJ
Date Rec' d
I White
Pink
Yellow
/tl5/o~
I PERMIT NO. 06 --Og-'73 ,
File
City
Applicant
ZONING (office use)
rr: AJ,E.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
~~
(Phone)
S' Co tT
(Address)
w,~ y-~4 Ct). (Phone) C2~J~r- C!)J-o/.f-
~ (Phone)_f~ .PI,).. - o/~..rt:f
~D/~ v:. ~
BUILDER
(Company Name)
(Contact Name)
;r.. I J-) ~S 0 c.f.".
--::r- ~
(Address)
/7/0
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration o Utility Conne non
CODE: ~R.C. OI.B.C. o Misc,
Type of onstmction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certity that I have hnnlshed mt"rmatllln on this applicatIon whIch IS to the best of my knowledge true and correct. I also certIfy that J am the owner or authOrIzed agent tor the
abovc-mentlllned pl'l1pcrry and that all c,mstructllln WIll conform to all eXIstIng state and loeallaws and will proceed in accordance with submItted plans I am aware that the bUlldmg
official can revoke this permIt for Just cause Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propelty to perform needed inspectIons
~~
Stgnature
x
~C--).o,).,(,s (,S
/b-.,J....o~
,
Contractor's License No,
Date
Permit Valuation 25CJo. Da
Permit Fee $ , / Lf', 7:;-
Plan Check Fee $ -
State Surcharge $ /,2-5
I Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
Application Becomes Your Building Permit When Approved
..
'''_lib-~ I()/ir ft (p
!;~lt~
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $
I Paid ~~,,~D
Date l5 It) fc
(
i ~~ceiPt ~2' '1'55
ThiS IS to certify that the request in the above application and accompanYIllg documents is III accordance with the City Zoning Ordinance and may procccd as requested ThiS document
when signed by the City Planner constItutes a temporary Certificate of ZOlllng compliance and allows construction to commence. Before nccupancy, a Certlficate of Occupancy must oe
issued
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