HomeMy WebLinkAboutBLDG 08-0153
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I White
Pink
Yellow
File
City
Applicant
PERMIT NO. C) 8 . /s- .3
,
~.F
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER &. /r.""o
(Name) . ~ty. y
(Address) A '3
i BUILDER ~
I (Company Name '(Ilk/ftJ
I
I (Contact Name)
S(p; 9)-1(
~/( V/E'~flul
/ft,J J S" flMj( V/~~ I};C
f}~ .5; ~
~~. C~,.;r:
(Phone) 90 ../fuft,-/so?.
(Phone) 79- 7&7. "959
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing "15(Jie-Siding
OAdditlOn OAlteration o Utility ConnectIOn r~'
CODE: kt R.C. DI.B.c.
Type of ~tmction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
OLower Level Fimsh
o Fireplace
o Mise.
PROJECT COST IV ALUE
(excluding land)
$ /;; / Ob 7. c.()
/
have turnished information on this application which is to the best llf my knowledge true and correct. I also certify that I ,1m the owner or ilutlHlrlzed agent for the
pert)' and that all constrllctlOn will conform to all eXIstmg state and local laws and will proceed in accordance with submitted plans_ I am aware that the building
I s permIt tllr Just cause Furthermore, I hereby agree that the City officialm a deSIgnee may enter upon the propelty to pertl)rm needed Inspections
"dOlt'o93o-J _#t1r
SIgnature Contractor's License No. Date
x
Permit Valuation ....-
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fe~ $
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ l~ -
-
: ~110fJ
I ~~ceiPt N oJ!: '5 ~s-c;-{o I
Paid
Date
ThiS IS to certify that the request m the above applicatlOn and accompanymg documents is 10 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner constitutes a temporary Certificate of Zomng complIance and allows cllnstruction to commence Before occupancy, a Certlticatc Df Occupancy must be
J.ssllcd
Planning Director
Special Conditions, if any
Date
24 hour notire for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372