HomeMy WebLinkAboutBLDG 08-0319
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Re.c ~ ~
~ ' Z .- CJY
I White
Pink
Yellow
File
City
Applicant
PERMIT NO.of. 3/
ZONING (office use)
3300
5r/'"vc<:- ~ I
Sw
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
eve'~r~en U/!.>trVC;LUJh
Sir>-r4>17 }='rc. /17e r
77?1 Ra- n'101( d 19-v~
~Sf - Ze:'?- 3131
(Phone)
(Phone)
PA-t/ / J?7 A/
(Address)
9,
'/'/ c:/
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Fimsh 0 Fireplace
OAddltion OAlteration o Utility Connec ion
CODE: OI.R.C. OI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
o Mise.
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S
PROJECT COST/VALVE
(excluding land)
$
V
I hereby certily that I have hlrmshed Inlormatmn on this apphcatJOn which IS to the best of my knowledge true and mITec!. I also certify that I am the owner or authorize,! agent tor the
above-mentlllned property and that ,Ill mnstructmn wdl conform to all eXIsting state and local laws and will proceed In accordance with submitted plans I am aware that the budding
oftjClal can revoke t1m permIt lorlust causc Furthermore, I hereby agree that the City official or a deSignee may enter upon the propeny to pertCllm needed inspectIons
~~~
Signature
x
b/-z/dd
Date
Contractor's License No.
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
! Plumbing Permit Fee $
MechanIcal Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
Water Tower Fee
Builder's Deposit
Other
#
This Application Becomes Your Building Permit When Approved
Buildlll!! Urtleial
Dale
ThIS IS to certIfy that thc request 111 the above apphcatlOn and accompanYll1g documents IS 111 accordance with the City Zonrng Ordinance and may pmceed as requested TillS document
when Signed by the City Planner constHutes a temporalY CertIficate of Zonll1g Cllmplrance and allows constructron to commence Before occupancy, il Certificate of Occupancy must be
issued
Planning Director
Date
2~ hour notirr for all inspections (952) ~~7-91'l50, fax (952) ~~7-~2~5
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any