HomeMy WebLinkAboutBuilding 06-0300
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
39// n~H S'T
Date Rec' d
er. Z -f'. 0&
White
Pink
3 Yellow
File
City
Applicant
PERMIT NO. Oft;. 0300
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
:'11 f/-1?/?f {J It-H! ~/3~'~L:-.
,~4-./t-.~17,5 j-
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
PID z.G". /(,0 OO.c. 0
.
(Phone)
/ ~2'-/ L-
C 1f-4.5 L(4- (.:J/1Jh / (;;; -r ';}-1:;4J~;;{;l) V4- ,-' (Phone)
)/-:1/14l(/i- c../~ /l....' (Phone)
C-I/:L f/l- /?7 "'z-/
~ (,2 - .3&:> Y-'-72> 15
'-(..L.......~3be -/);3
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Conne
ORe-Siding OLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.c. o Misc.
Type of Construction: I II III IV V A B c; Z,)Dl; c""Z--'
PROJECT COST IV ALUE $
Occupancy Group: A II E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certify that 1. h~OV.,.."' . rmShed, mf',JI'motion on this opplicatlOn which IS to the best uf my knowledge true and correct. I also certIfy thot I am the owner or auth, onzed agent for the
above.mentlOned propelTy t at all CllnstructlOn WIll cont(Jrm to oIl existIng state and local laws and will proceed In occordance with submItted plans. I am oware that the bUIldIng
" loal can revoke tl:IS P." mlt r Jus~~ermore, I hereby ogree that the CIty officiol or a ~eslgnee may enter upon the property to perform needed mspectlons
Xi.. i <t/~ I-I/<~~
. Signature Contractor's License No, te
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Blllldll1g Oniclal
Date
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 $ /(,.00
, (J t.
ThIS IS to certify that the request 111 the obove applicallon and occompanymg documents is in accordance with the City Zoning Ordinance and moy proceed as requested ThIS document
when ~ignl'd by the City Planner constItlltes a temporary Certificate of Z011lng compliance and allows construction to commence Before occupancy, a Certificate of Occupancy must be
isslIcd
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