HomeMy WebLinkAboutBuilding 06-0789
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
? 26.0"
It, /B 0 e:YI'tAlJr?JtJ /f1/e.
I White
Pink
:; Yellow
File
City
Applicant
\ PERMIT NO. 0(,. (J 789
I
ZONING (office use)
LEGAL DESCRIPTION (olTtce use only)
LOT
BLOCK
ADDITION
PID z..s-. 00 I. 082,. I
OWNER
(Name)
ZL~I--VHj)
..joz..
(Phone)
q 5~ -'-Il.{O....1 (>~
(Address) I
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck DPorch 0Re-Roofmg ORe-Siding DLower Level Finish 0 Fireplace
o Addi1:ion DAlteration DUtility ConnectiOn
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV
H I
2 3
V
M
4
A
R
5
U
PROJECT COST IV ALUE
(excluding land)
o Misc.
B
S
$
I hereby certity that I have furnished mlt)rmatlOn on this application which IS to the best of my knowledge true and correct. I also certify that I am the owner or authonzc(j agcnt Itll the
above-mentIOned property and that an ClJnstruction will conform to all existing state and local laws and will proceed in accordance with submItted plans I am aware that the bUIldmg
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Signature Contractor's License No Date
Permit Valuation Z, S () C. () 0
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildll1!! Ofticlal
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 $
This IS to certify that the request in the above applical10n and accompanymg documents is m accordance with thc City Zllning Ordinance and may prlleeed as requested TIllS dllcument
when signed by the City Planner consl1tutes a temporary Ccrtitkate of Zonrng compliance and allllws Cllnstruel10n to commence Bdore llcCUpancy, a Certificate llf 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