HomeMy WebLinkAboutBLDG 07-1125
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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Date Rec' d
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I PERMIT NO.
File
City
Applicant
7-11l-r-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
(Address)
BUILDER ""'" l J P
(Company Name) -lI~ f~C) t\ rV .
(Contact Name) Ln~'~(~ I;] dk-Lt~
(Address) d 0 ~
(Phone)
iR I?- 70 J 9?-111
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TYPE OF WORK 0 New Construction ODeck o Porch lSIRe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn o AlteratIon o Utility ConneoCon
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III
H
2
IV V
I M
3 4
o Mise
tlOOO~-~-
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
\.)' ation on this applicatlOn which IS to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
II constructIon will eonflllm to all eXIsting state and local laws and will proceed In accllldance with submitted plans I am aware that the building
t c use Furthermore, I hereby agree that the Clty official or a designee may enter upon the prope11y to pertc)rm needed spectHl S
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x
Signature
Permit Valuation
Permit Fee $ 7 ro i-D
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $ I
omes Your Building Permit When Approved
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Date
Contractor's License No.
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 $ 7G0!
Paid
Date
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I ~~cei~
.sY-U~1
ThIS 1S to certify that the request III the above appl1catlOn and accompanYlllg documents is III accordance with the City Zoning Ordinance and may proceed as requested TillS document
v.'hen signed by the City Planner constltutcs a temporary Certificate of ZL>nmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy mllst be
isslled
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (<)52) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372