HomeMy WebLinkAboutBLDG 07-1043
CITY OF PRIOR LAKE BUILDING PERMIT,
TEM Y CERTIFICATE OF ZONING COMPLIANCE
UTILITY CONNECTION PERMIT
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I PERMIT NO. 07. I 0 tJ I
File
Cjty
Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address) ~,
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(Phone)
(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
OAdditlOn DAlteration o Utility ConnectIon
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
o Mise.
B
S
PROJECT COST IV ALUE
(excluding land)
$
U
x
I hereby certity that I have hlrmshed information on this applIcatIOn whICh IS to the best of my knowledge true and mITecL I also certify that I am the owner or authorIzc,! agent tt,r the
abovc-mentwned property and that all Cllnstructlon will eontlrrm to all eXlstmg statc and local laws and Will proceed 10 accordance with submItted plans I am aware that the blllldlng
official call revoke thiS permit for Just cause Furthermore, I hereby agree that the CIty official or a deSignee may enter upon the prOpeJ1y to perf()rm needed lf1Spcctlons
--.LV -2-(;- 07
Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechamcal Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Permit When Approved
Iluildlllg Of!iclal
Dale
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I", $
Pressure Reducer $
Sewer/Water Connection Fee # S
Water Tower Fee # $
Builder's Deposit I $
Other $
TOTAL DUE $
ThiS IS to ceftIfy that the request In the above applicatlOI1 and accompanYing documents IS in accordance with the City Zoning Ordinance and may pJ'ncl'cd as requested. ThiS document
when signed by the City Planner CllllstltLltL'S a temporary Certificate uf Zonmg compliancl' and allows constructIon to commence Before occupancy, a Certificate Ill' Occupancy must he
isslIcd
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