HomeMy WebLinkAboutBLDG 08-0343
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Re~. '; d;}
&~ r. 06
n at bottom)
I White
Pink
YellO\v
File
City
Applicant
I PERMIT NO. 0 tJ _ 031-.3/
ZONING (office use)
T;(J tkr 5
r~.
1JL
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER ... f rJz ~ .'
(Company Name) r/ r 5> ('1 I))U i?v;. ..Iclo I' )
(Contact Name);,.::>", ~ p "-
(Address) :to '-IS- Pi-.
In'- .
(Phone)
(Phone)
O<:/q
"J ;;-'7h )- '~q<S
.
TYPE OF WORK 0 New Construction ODeck OPorch
OAddillOn OAlteration OUtility Conne
ORe-Siding OLower Level FinIsh 0 Fireplace
CODE: OLR.C. OLB.C. o Misc. ~---
Type of Constmction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby cl'ltity that I have lurOlshed mlormatllln on this apphcatllln which IS to the best of my knowledge true and coITect. I also certify that I am the owner or authmlzed agent Illl the
above-mentlllned pmpcrty and that all ('onstructllln wIll contlllm to all eXlstmg state and local laws and will proceed m accmdance with submitted plans I am aware that the buildmg
official can lTVD - -rmIt for Just C,luse Furthermore, I hereby agree that the CIty official or a desIgnee may enter upon the property to perform needed lOspcctrons
.;)-0 '] I 7 7 7 r-
6~
x
Signature
Contractor's License No.
y....
G- <7-0
Date
Permit Valuation
Permit Fee
$
$
$
$
$
$
I $
$
Park Support Fee
SAC
#
#
$
$
$
Plan Check Fee
Iluildtng Unieial
Date
Water Meter Size 5/8"; I",
Pressure Reducer
Sewer/Water Connection Fee
#
#
State Surcharge
I Penalty
I Plumbing Permit Fee
l~eChanical Permit Fee
Sewer & Water Permit Fee
Water Tower Fee
Builder's Deposit
Other
Gas Fireplace PermIt Fee
TOTAL DUE
-
This Application Becomes Your Building Permit When Approved
ThiS IS to certify that the request In thL' above applicatlOn and accompanYIng documents IS In accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner (Unstlttltes a temporary Certificate of Zonlllg compliance and alltJws construction to commence. Before lKcupancy, a Certificate {If Occupancy must be
issued
Planning Director
Date
24 hour nolirr for all inspertions (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any