HomeMy WebLinkAboutBLDG 07-0863
CITY OF PRIOR LAKE BUILDING PERMIT,
TEM~Q.BA.R.~ CERTIFICATE OF ZONING COMPLIANCE
~. - AND IT ONNECTION PERMIT
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. n at bottom) i
ADDRESS
l~ 1~o
Date Rec' d
~/'ol(J 7
I White
Pink
Yellow
[ PERMIT NO. 07-(0(03
File
City
Applicant
ZONING (office use)
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID
OWNER ./\ .8
(Name) ~Rr.er 'C\C(
(Address) lCo<{~U
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
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--.,
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LfCt 1- 3?'i d--
TYPE OF WORK 0 New Construction ODeck OPorch iX"Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditIOn OAlteration o Utility Conn~n
CODE: ~.R.C. OLB.C.
Type of <to~stnlction:
Occupancy Group: A B
Division:
I
E
II
III
H
2
IV V
I M
3 4
o Misc.
A
R
5
B
S
PROJECT COST IV ALUE
(excluding land)
$
-r Lf <-to . QU
U
I hereby certity that I have furmshed mfmmation on this applicatIOn which IS to the best of my knowledge true and coITect. I also certIty that I am the owner m authollzed agent tm the
Jbnvl'-rncntlOned property and that ,lll constructaJn will conform to all eXIsting state and local laws and will proceed in accordance with submitted plans. I am aware that the ouildlOg
otlicial can feVl kc thiS ptTmlt for Just cause Furthermore, I hereby agree that the CIty officiallJr a deSIgnee may enter upon the propeI1y to pertc)rm needed tnSpcctlOlls
X' nvA,~ ~()J ~:l;/75 q/10kL_
Sign/rure Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace PermIt Fee
:;25"'0-0 , 0 ~
$ ,75;"
$
$
$
$
$
I $
$
-
.2~
This Application Becomes Your Building Permit When Approved
~~
lluddlllg Urticial
<J !fO(07
I ate
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water ConnectIOn Fee # $
,
Water Tower Fee # $
Builder's Deposit i $
Other $
TOTAL DUE $ 7fn, 0 0
I P,id ir~Io''''''
Date (I D/07
v~
I ~~ceiio. 5L1lDzt{
-1-.
f~ .
51 (J "
ThIS IS to certify that the requl'st tn the above applicatIOn and accompanymg documents is in accordance with the City Zoning Ordinance and may prncl'l'd as requested ThlS d()Cument
whcn signcd by the City Planner constItutes a temp"rary Certificate of ZOnIng compliance and allows constructIOn to commence Bctore occupancy, a Certlticate of Occupancy must be
isslled
Planning Director
Special Conditions. if any
Date
24 hOllr notice for all inspections (952) 447-9R50. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372