HomeMy WebLinkAboutBLDG 07-0988
TY OF PRIOR LAKE BUILDING PERMIT,
Y CERTIFICATE OF ZONING COMPLIANCE
UTILITY CONNECTION PERMIT
TEMPO
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(Please
ADDRESS
15/
Date Rec' d
1 White
Pink
Yellov.
loj/-07
I PERMIT NO. () 1- (J crfrcf' I
File
City
Applicant
ZONING (office use)
t1 Ls {;-.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
()enn/5
/5/ ~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
Y4'1,.{,C~L
(Phone)
(Phone)
<t'i~~3?r ~
-
TYPE OF WORK 0 New Construction ODeck OPorch ~e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration o Utility Connection
CODE: bl.R.C. DI.B.C.
Type of a;;;.stmction:
Occupancy Group: A B
Division:
I II III
E@~
IV V
I M
3 4
o Mise
A
R
5
& 100. tJO
B
S
PROJECT COST IV ALUE
(excluding land)
$
U
I hereby certify that I have hlrnishcd infOrmatIOn on this applicatlOI1 which IS to the best of my knowledge true and correct. I also certIfy that I am the owner Dr <luthonzed agent f()J" the
Jb<lve-mentloned property and that all Cllnstructwn Will contlJrm to all eXlstmg state and local laws and will proceed in accordance with submltled plans I am aware that the bUlldmg
;rIClal/?;;;z::ust c~ hereby agree that the City official l~;~ m; ;~r ~the propel1y to pertlllm nee~: ;S;~ll;~ 7
Signature ~ Contractor's License No Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
-
, 'Z};-
Sewer & Water Permit Fee
Gas Fireplace Permtt Fee
This Application Becomes Your Building Permit When Approved
~ -:f<~U
I Buildl11g Ufticial
/0/' zit!) 7
.
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 $ 7(_ . (JO
-..-
it~ ,,0
;'2 fO?
-Jt;.. 5V liD
~
Receipt No. 5"cjgZ6
~.
Paid
Date
By
C,1,.
ThiS IS to certify that the request 10 the above applicatlOn and accompanYll1g documents is 1I1 accordance with the City Zoning Ordinance and may procecd as requested ThiS document
when signed by the CIty Pl.mner constItutes a temporary Certificate uf ZOl11ng cDmphance and allDws Clmstructllln to CDmmence. Bcfme Dccupancy. " CertIficate Df Occupancy must be
issued
Planning Director
Special Conditions. if any
Date
24 hour notice .for all inspections (952) 447-9850, fax (952) 447-.t245
4646 Dakota Street Prior Lake, MN 55372