HomeMy WebLinkAboutBLDG 07-1097
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ADDRESS
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LEGAL DESCRIPTION (office use only)
Date Rec' d
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I White
Pink
:; Yellow
File
City
Applicant
PERMIT NO.7. 10 97
ZONING (office use)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
511
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(Phone)
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(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration OUtility Conn tl n
CODE: DI.R.C. DI.B.C. o Mise. -~--
Type of Construction: I II III IV V A B PROJECT COST /V ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certIly that I have furnIshed rnformatllln on this application which IS to the best of my knowledge true and eDrrect I also certify that I am the owner or authollzed agent lor the
above-mentioned property and that .111 construction WIll conform to all eXlStrng state and local laws and Will proceed 10 accordance WIth submitted plans I am aware that the bUlldrng
otflClal can re~~)ke t1~ p~t tin Just C, se ,Furthermore, I hereby agree that the City otflcial or a deSignee may enter upon the propel1y to perform needed ,mspectllms
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Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
This Application Becomes Your Building Permit When Approved
Blllldlllg Uniclal
Datc
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 $
ThIS IS to certify that the request III the above appltcatllln and accompanymg documents IS m accordance with the City Zoning Ordmance and may proceed ,lS reqllested TIllS doellment
when signed by the CIty Planner constitutes a temporary Certificate llf Zomng eDmpltance and allllws eonstruCtllln to commence Before occupancy, .1 Certltieate of Occupancy must be
issllnl
Planning Directllr
Special Conditions, if any
Date
24 hour notice for all inspections (952) ....7-9850. fax (952) ....7-..2..5
4646 Dakota Street Prior Lake, MN 55372