HomeMy WebLinkAboutBLDG 07-1093
CITY OF PRIOR LAKE BUILDING PERMIT,
RARY CERTIFICATE OF ZONING COMPLIANCE
ND UTILITY CONNECTION PERMIT
Date Rec' d
II. /3,07
File
City
Applicant
I PERMIT NO. 07./09-3 ,
I
ZONING (office use)
I White
Pink
Yellow
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
1G-;}]b-1lf4Y
i BUILDER I '.1'
I (Company Name) !-) L s:.L
I (Contact Name) Le..{>'''IAo'' L
I (Address) 14 (6 i\ ~~
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TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
OAdditlOn OAlteration o Utility Conne tIon
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Mise
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certity that I have hlfnishcd mformatio!1 on this application which IS to the best nf my knowledge true and COlTect. I also certIfy that I am the owner O!" aut!lonzed agent for the
JhllYC-mclltlOl1cd property and that all constructIOn will conform to allexlstmg state and local laws and will proceed in accordance with submitted plans_ 1 am aware that the buildmg
~m"" "" '''ok. <c'" , " ,,,' ,,," Y"''"'" mo", I h'''h, ,,'N '"" .hoc.., .."d,' .., , "".,"" m" '00" ",m, ,", ,...,m, m ''''mm ""'tl:"ifJ- 15 L
19nature Contractor's License No Date
Permit Valuation
Park Support Fee
SAC
#
#
Permit Fee
$
$
$
$
$
$
I $
$
TOTAL DUE
Plan Check Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
State Surcharge
I Penalty
I Plumbing Permit Fee
~I Mechanical Permit Fee
Sewer & Water Permit Fee
i Gas Fireplace PermIt Fee
Water Tower Fee
Builder's Deposit
Other
This Application Becomes Your Building Permit When Approved
Huildlllg Urticial
Date
$
$
$
$
$
$
I $
$
$
(P.oO
ThiS IS to certIty that the request in the above application and accompanymg documents is 10 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner constItutes a temporary Certificate of ZonIng compliance and allows construction to commence. Bcfllre occupancy, a CcrtlfiC<lte of Occupancy must be
IsslIed
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions. if any