HomeMy WebLinkAboutBuilding 07-0628
Date Rec'd
I. / Y {.J 1
CITY OF PRIOR LAKE BUILDING PERMIT,
T~~~Y CERTIFICATE OF ZONING COMPLIANCE
Q,\~ ~,~XND UTILITY CONNECTION PERMIT
fb ~lw(,b8 : E. ZS... I PERMIT NO. oJ OG z.0
(Please type or ~ 11II11 sil!! at bottom)
153~n tWI,^-,r fuU rd {\lB-, rhiw Lili, mAJ I ZONlNGt__> I
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK \ ADDITIONfter-SmS J st A-ottA.vfze,ryV
PIDo5-()61 D03-D
OWNEll fl
(Name) ~1hcl( ((,\
(Address) :5 2> fS '\; Lttr I
(phone) q SJ.~\..j LJ S-to 0'+ 0
BUD.J>Ell
(Company Name)
(Contact Name)
(Address)
(phone)
(phone)
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Con
CODE: OI.R.C. OI.B.C.
Type of Coastruction: I
Oexupancy Group: A B E
Division:
n
F
1
m IV V A B
HI MRSU
2 3 4 5
-Roofing OR.e-Siding OLower Level FiDlsh 0 Fireplace
n 0 Misc.
PROJECT COST IV ALUE S
(excluding land)
'1,000.00
.
1 hereby certilY that I have fumishecl information on this application which is 10 the best of my knowled8e true and comet. J also certifY that 1 am the owner IX" authonzcd apt lilr the
above-menboned JlI'OJlfflY and that all construction will conform to all existillll state and local laws and will proceed in aCl:llrllan<< with submitted plans. 1 am awa~ that Ihe buildina
official can uvokr this permit ~~ cause. Furthermore. I hereby agree that the city official or a desisnee may enter upon the JlI'OJlfflY to perform needed mspcclions.
X ~hl1/\.~ c.. r\f}t:fl~ ----.:1- I ~- 0 7
Signature Contractor's License No. D.~
Permit Valuation
Permit Fee S
Plan Check Fee S
State Surcharge S
Penalty S
Plumbing Permit Fee $
Mechanical Permit Fee S
Sewer elk Water Permit Fee S
Gas Fireplace Permit Fee S
This Application Becomes Your BuilllinI Permit When Approm
Buildin2 Official
Dale
Park Support Fee # $
SAC # S
Water Meter Size S/8"; I"; $
Pressure Reducer S
SewerlWater Connection Fee # S
Water Tower Fee # $
Builder's Deposit S
Other S
TOTAL DUE S
This is to certifY that the mjUest in the a~ application and accompanyina documents is in accordllllee with the City Zooina Ordinance and may proceed as mjU~. This document
when siped by the City Planner constitutes a temporary Certificate of Zooina compliance and allows construc:tion to commrnce. Before occupancy, a CertifICate of Occupancy must be
issued
PIamIing Director
Date Specia1 CoIIditiona. if my
24 hour notice for all inspections (~2) 447-98~. fax (m) 447-4145
16200 Eagle Creek Avenue Prior Lake, MN 55372