HomeMy WebLinkAboutBuilding 06-0844
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
rt/e~~
I White
Pink
Yellow
File
City
Applicant
\ PERMIT N~-C844-
(Please
ADDRESS
ZONING (omce use)
.3St,~ /ft1J.fWtn.t)
U1C-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID z.r 110. Ol,y. 0
OWNER
(Name)
Wo- -J-e-
f/ l/,i/0 V ~
. (
(Phone)
(Address)
TYPE OF WORK 0 New Construction ODeck
DAddition OAlteration
(Phone)
(Phone)
~q J- .. 6 (".J J )--. (9 ~
;).7 O~ 7/9 J..
BUILDER
(Company Name) ) ~fV"'I
(Contact Name) ::;-. ~
(Address) ;)"k
JrY1
.y----
ORe-Siding OLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.c. o Misc. .~
Type of ConstnIction: I II III IV V A B PROJECT COST IV ALUE $~ ~(jdJ t:'/()
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 rp
I
I heleby ceJlIfy that I have turOlshed 1I1~lllm tlDn Dn thIS applIcallD Whle~ i III the best Df my knDW.lcdge true and CDrreCI. I also certify that I am the owner or auth.OrIZed agent for the
above-mentIOned plOpeny and that all luetlon WIll conform all ~ias ng state and local laws and WIll proceed In accordance With submItted plans I am aware that the blllldIng
otliClal can revok > se FlllthelmOle, I hele agr' t t the City official or a deSIgnee may enter upon the propelty III perform needed InspectIons
/
./
Contractor's License No.
~-/6--0-f,
Date
Water Tower Fee
#
#
$
$
$
$
$
$
$
$
$
~
Gas Fireplace Permit Fee
$
$
$
$
$
$
I $
$
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee
Plan Check Fee
Water Meter Size 5/8"; 1";
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Pressure Reducer
Sewer/Water Connection Fee
Sewer & Water Permit Fee
Builder's Deposit
Other
Buildll1l! OffiCial
Date
s;
TOTAL DUE
This Application Becomes Your Building Permit When Approved
ThIS IS to certify that the request In the above application and accompanYIng documents is in accordance With the City Zoning Ordinance and may procecd as requested. Tim document
when signed by the City Planner Cllllstltutes a temporary Cenifieate of ZOnIng complIance and allows cOllstrucllon to commence Hd,)re occupancy, a Certificate of Occupancy must be
isslIed
Special Conditions, if any
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372