HomeMy WebLinkAboutBuilding 06-0249
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
4-, /O.oG
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 00 . 6 z.411
(Please
ADDRESS
1ft L031os-
I
lXL..
;:: R/-j tV J::. /- / N'
ZONING (office use)
LEGAL DESCRIPTION (office use only)
I
PIDZS-. 0 Cr. cC S-. I I
(phone) 74.3 -6-6-7 -OS'G:. ~
I
LOT
BLOCK
ADDITION
OWNER ~
(Name) . IJ "V
61J{)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck o Porch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connec IOn
CODE: DI.R.C. DI.B.c. o Mise ---
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby Ccrtlfy that I have furnIshed mfmmation on this application which IS to the best of my knowledge true and CO!Tec! I also certIfy that I am the owner or authorIze,j agent fl)r the
above-me cd property and that all constructIon will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
omc a evoke tlm permIt for Just cause Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the property to perform needed mspecl10ns
Contractor's License No.
Permit Valuation
Park Support Fee
SAC
#
#
Permit Fee
$
$
$
$
$
$
I $
$
TOTAL DUE
Plan Check Fee
Water Meter Size 5/8"; 1";
State Surcharge
Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
t.... t/U
/1. (1&.,
This Application Becomes Your Building Permit When Approved
Buildll1~ Official
Date
'I--I/)- Oh
Date
$
$
$
$
$
$
$
$
$
ThIS IS to certify that the request in the above applicatIOn and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested nus document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Bcfore occupancy, a CertIficate of 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