HomeMy WebLinkAboutBuilding 06-0831
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
r; 12.,0 G
File
City
Applicant
PERMIT NO. t1 c:'. 0 a 31
] White
Pink
Yellow
at bottom)
ADDRESS
7J 1'1 () 7H1/
/+? 7 /
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID z.~ ./"Z.4-. ():77. ()
OWNER
(Name)
(Phone)
,
'1S-~ -1<17 -'-/it (,7
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Conne
ORe-Siding
OLower Level Finish
o Fireplace
Re-Roofing
ron
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
o Mise.
B
S
IV V
I M
3 4
A
R
5
III
H
2
II
F
1
I
E
U
PROJECT COST/VALUE $
(excluding land)
I hereby certify that 1 have hlrnlshed mformarion on this application which IS to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
above-me oned propelty and that all construction Will conform to all eXlstmg state and local laws and will procced in accordance with submitted plans. I am aware that thc buildmg
official c evoke thiS per for Just cau Furthc orc, I hereby agree that the City official or a designee may enter upon the propeny to perform needed mspectHlns.
Contractor's License No.
Permit Fee
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
Buildin!! Otliclal
Date
Date
$
$
$
$
$
$
$
$
$
ThiS IS to certify that the request m the above application and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested. TIllS document
when signed by rhe City Planner constltutes a temporary Certificate of Zonmg comphance and allows construetlon to commence. Before occupancy, a Cemticate uf Occupancy must be
issued
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