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HomeMy WebLinkAboutBLDG 07-0860 Date Rec' d CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE QbSQ... ~t,,\, AND UTILITY CONNECTION PERMIT (?B 5"/~O ~ , RoJ A:~ n at bottom) (Please ADDRESS ~~ . ~' c- LEGAL DESCRIPTION (ofllce use only) LOT ADDITION BLOCK OWNER (N ame) (Address) 4b/J1t hJ4.V1. 51:.1 ;./-' - S" ~:. BUILDER (Company Name) (Contact Name) (Address) 1 WI"Hte Pink Yellow FIle City Applicant PERMIT NOt> 1- SGo PID (Phone) tl'f7- & ~~ ~~y [2J-k,;.J (Jk.s-4-c,{,tf~ ~()., "2- J H- ;-.J.- Z (Phone) (Phone) TYPE OF WORK DAdditlon DI.B.c. Type of onstmction: Occup cy Group: A B Division: II F I III IV V A HIM R 2 3 4 5 I E ~ 9':"1.. - 2L{ () -- ~~ (J 7 ~. ?'':Y 2 - 46/- ] 3 3 (, &'r7 I ~t DLower Level finish 0 fm:placc B S U ( .----- S", Ct:>v . PROJECT COST IV ALUE $ (excluding land) I herehy certify that 1 have hlrnishcd mformatIOn on this applicatlOl1 which 15 to the hest of my knowledge true and COITect. I also certIfy that I am the owner Ol" authOrIzed agent for the above-mentlll . and that all eonstru w II Cllnttllm to all eXisting state and lllcallaws and will proceed in accordance with submltled plans I am aware that the burldll1g offICial' revoke tl1 > cr It for Just cause urthef re, I hereby agree that the CIty official or a deSIgnee may enter upon the prope11y to perform needed 10 ectlqns Permit Valuation Permit Fee $ Plan Check Fcc $ State Surcharge $ Penalty $ Plumbing Permit Fee $ Mechanical Permit Fee $ Sewer & Water Permit Fee I $ $ :ZO'f)i2-i Ii Contractor's License No. ~ Park Support Fee # $ SAC # $ Water Meter Size 5/8"; 1"; $ Pressure Reducer $ Sewer/Water Connection Fee # $ , Water Tower Fee # $ Builder's Deposit I $ Other $ TOTAL DUE $ 7~ - I P,id -~(~ Date It 0 / 1 / I Receipt No ~0I3 By r2./) , . Thls IS to certify that the request in the above applicatlOJ1 and accompanYll1g documcnts IS 111 accordance with the City Zuning Ordinance and may proceed as requcsted ThiS dllCumcnt when signed by the City Planner constitutes a temporary CertIficate of ZDnmg compliance and allows construction to cummence. Before uccupancy, a Certificate of Occupancy must be issued Planning Director Special Conditions. if any Date 24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245 4646 Dakota Street Prior Lake, MN 55372