HomeMy WebLinkAboutBLDG 07-0989
Date Rec' d
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ADDRESS
! {p '}, 81
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/6/IL;" 7
I PERMIT NO'07-0Qij I
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Yellow
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City
Applicant
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
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(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
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(Phone)
(Phone)
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I hereby certify that I haw hllOlshed mformatlon {1Il this application which IS to the best of my knowledge true and CO!Tect. I also cel"tlty that I am the owner {)t authot!zed agent tor the
,lbllVl'-ment1l1ned property and that all CllllstrUCtlon Will cont()rm to all eXIsting state and Incallaws and will proceed in accordance with submitted plans I am aware that the bUlldmg
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SIgnature Contractor's License No. Date
TYPE OF WORK 0 New Construction ODeck OPorch
OAddltion o Alteration o Utility Conne
CODE: ~.R.C. OI.B.C.
Type of ~stmction:
Occupancy Group: A B
Division:
II
III
H
2
IV V
I M
3 4
Permit Valuation
Permit Fee
Plan Check Fee
-
~
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
$
$
$
$
I $
I $
,2S-
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
r
I()/'~Io?
I Date r
..
OLower Level Finish
o Fireplace
e-Roofing
ton
ORe-Siding
o Mise
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # $
Builder's Deposit I $
Other $
TOTAL DUE $ 7tc,00
Paid --rID,OO
Date JtJ( ,...; () 7
~.. 5'100
I ~~cei~. ~q i 'Z-P
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ThIS IS to certify that the request m the above application and accompanymg documents IS m accordance With the City Zoning Ordmance and may proceed as requested. Tim document
when signed by the City Pl,mner nlllstltutes a temporary Certltlcatc of Zllllmg compliance and allows construCl1on to commence. Before occupancy, a Certificate of Occupancy must be
i,Ss II cd
Planning Director
Special Conditions, if any
Date
24 hOllr notice for all illspections (952) ~~7-9115n, fax (952) ~~7-~2~5
4646 Dakota Street Prior Lake, MN 55372