HomeMy WebLinkAboutBLDG 07-0777
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMpt RY CERTIFICATE OF ZONING COMPLIANCE
~ ~ ~~\.e- D UTILITY CONNECTION PERMIT
G\~q\t0 ~ ~
lit. \\\ V,\ h
lD0J () eJ-'\
i\(
Date Rec' d
<l/ I eol 0 7
I White
Pink
Yellow
I PERMIT NO. ()7 -077 7
File
City
Applicant
\+.
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNE~
(Name) t-iY
(Address)
c:
(Phone)
~~
'..-/ I
Cc-~
CJ<;a L{!:1r 'tM
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
DAddition DAlteration DUtility Connection
CODE: !I.R.C. DI.B.c. o Mise.
Type of onstmction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: (!9 2 3 4 5
I hereby certify that I have hlrnished Information un this applicatIOn which IS to the best of my knowledge true and COlTcct I al.so cntlfy that I am the owner or authOrIzed agent t~)!' the
abllw-mentlOned property and Ihat all Cllnstructlon Will contllrm to all eXistIng state ,1l1d local laws and will proceed In accordance with submItted plans I am aware that the buildmg
official can 1 vo IS permIt fm . t cause Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the property to perform needed inspections
8'-/6-,
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
,----
I I '2--5"
$
$
$
I $
$
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
'QPPlicatiO: Be~s :: ~~r Building Permit When Approved
~ ~ ~/~/o7
.
Iluildlllg Onicial
Date
Contractor's License No
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I", S
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # $
Builder's Deposit I $
Other $
TOTAL DUE $ 7~ .00
Paid 7(P.06
Date VI' r..(crr
Receipt No. 5"45'1./?
77r
By
ThIS IS to certify that the request in the above application and accompanY1l1g documents is lI1 accordance with the City Zoning Ordinance and may pn)ceed as requested Thls dllClImel1t
when signed by the City Planner constitutes a temporary Certificate uf Zunmg complI.mcl' and allows construction to commence Before occupancy, a Cntltlcatc of Occupancy must be
issllcd
Planning: Director
Special Conditions, if any
Date
24 hour notier for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372