HomeMy WebLinkAboutBuilding 06-0250
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
/~ Z-Btj63
.
F /Crt A/K (,1 A/ 7"/c. L.
Date Rec' d
4-. /0, 00
I White
Pink
Yellow
I PERMIT NO. 0(,. CJZ50l
File
City
Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2S-' lJZ';-.o02-. j
OWNER ~
(Name) f?f'IJN
0170
(Phone)
7(, ~ - 2- '7 - OS-6~
I
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition o Alteration OUtility Conn tlOn
CODE: DI.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
o Misc.
A
R
5
B
S V
PROJECT COST/VALVE
(excluding land)
$
I hereby certify that I have furnIshed InformatIon on this applicatIOn whIch IS to the best of my knowledge true and correct. I also certify that I am the owner or authOrIzed agent fllf the
above-mentIon' roperty and that all construction will conform to all existIng state and local laws and will proceed in accordance with submitted plans I am aware that the buildIng
offiCIal ca vo' thIS permIt for Just call ermore, I hereby agree that the City official or a deSIgnee may enter upon the propelty to perform needed InspectIOns
~
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I
I Plumbing Permit Fee $
I
Mechanical Permit Fee $
r Sewer & Water Permit Fee I $
I Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Blllldlllg OffiCial
Date
Contractor's License No.
,/-/t> '-O~
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 DVE $ 1'7w. 00
,
t No. .5/J30
ThIS IS to certIfy that the request in the above applrcatIon and accompanymg documents IS m accmdance with the City Zoning Ordinance and may proceed as requested TIllS document
when signed by the CIty Planner CDnstItutes a temporalY Certificate of Zonmg complrancl' and allows construction to commence Before occupancy, a CertIficate of Occupancy must be
1.SS11Cd
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