HomeMy WebLinkAboutBLDG 07-0942
CITY OF PRIOR LAKE BUILDING PERMIT,
CERTIFICATE OF ZONING COMPLIANCE
g~ kf:~D ITY CONNECTION PERMIT
~r ~~~8 1= ~
Yellow Applicant
(Please
ADDRESS
59;3 S-
Date Rec' d
/0, l,.., OJ
I PERMIT NO.07 O*~
lei LJ t9-G
ZONING (office use)
~.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
tf/,i~
~Iu.v
(Address)
(Phone)
fa /2 - 7t/3 -t;, I )/9
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level FinIsh D Fireplace
DAdditlOn DAlteration DUtility Conn tlO
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
o Misc.
B
S
PROJECT COST /V ALUE
(excluding land)
$
U
I hereby certify that I have hlrmshed information on this appltcatlon which IS to the bcst of my knowledge true and correcl I also certify that I am the owner or authonzed agent fm the
above-mentioned property and that all construction will contllrm to all eXisting state and local laws and will proceed in accmdance with submltted plans I am aware that the building
~ljC1al can revok' hs per It till J cause Furt~ I hereby agree that the City official or a deSignee may enter upon the propel1y to pertlJrm n;;d ~~s~t:1S0 7
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
! Penalty $
I Plumbing Permit Fee $
I
Mechal1lcal Permit Fee I $
Sewer & Water Permit Fee I $
I
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Permit When Approved
l~uIldl1lg Unieial
Date
Contractor's License No. Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $
ThiS IS to certify that the requl'st In the abuve application and accompan)'lllg documents is 10 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
whcn signed hy the City Planner CLJl1stltutcs J temporary Certificate of Zonmg compliance and alhlV.'s construction to commence Before occupancy, a CCftlticatc ()f Occupancy must be
i,"iS1Icd
Planning Director
Special Conditions. if any
Date
24 hour notirr for all inspertions (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372