HomeMy WebLinkAboutBLDG 08-0338
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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City
Applicant
I PERMIT NO. OB OJJI{ I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
II V\Il
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(Address)
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P Vl6V
(Phone) q Sl '4:41 ' {p~ ~ 4-
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BUlLDEll (dVl'\VZ\ [~ ,
(Company Name) . S ~ I"- mr"'. .;~{. I 0 vS, l L C
(Contact Name) ~ rJY\ I \J v V\ X. tt
(Address) 0 . U lP ~ V " IZ.V
(Phone) q ) 1 . 4fv, 11/1t17
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition DAlteration DUtility Connection 0 Misc.
CODE: OI.R.C. OLB.C. PROJECT COST/VALUE S L-b DO, 00
Type of Construction: I II ill IV V A B (excluding land)
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
I htTeby certify thaI I have furnished information on this application which is to the best of my knowledge true and correct. J also certify that I am the owner tlr authorized agent for the
above-menlloned property and that aU construction wiIl conform to all existing state and local laws and will proceed in accordance with submitted plans. J am aware thatlhe building
:""'~ - t' V 7"r" ;;~ ""'" "'" ",moo, ""Z'n4-"'"ti' il ~S'k: m, -., ,. ",- ""0' rgo~
Si ture Contractor's License No. Date
Permit Valuation
.
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
Building Ollicinl
Date
Park Support Fee # $
SAC # $
Water Meter SizeS/S"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $
ThIS is to certify [halthe request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutcs a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning DiIector
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372