HomeMy WebLinkAboutBLDG 07-0938
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
{2LOSL ~ ~~tTlLITY CONNECTION PERMIT
s?Ye
4998
IfL,/f~ GMc-.
Date Rec' d
/v . j, () 7
I White
Pink
Yellow
I PERMIT NO. 07 0738 I
File
City
Applicant
/CLJ
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER )
(Company Name) L $" L e.si Lr...C.
(Contact Name) ~t.''''A;i ~h..~ ~
(Address) \ ~ ( bl\ l-\- ~ -&, J\)~~ ~ " "
-LA ~;'I
~~
(Phone)
(Phone)
SS'";~ 4
q$i -.l.J t.. ~ gLt '1lf
Q {..,/~. .l"~-411f"':l
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 FirepLlCe
OAdditlOn OAlteratlOn o Utility ConnectIOn
CODE: OI.R.C. OI.B.C.
Type of Constmction:
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
I hereby certify that I have hlfmshed mfnrmation lJll this application which is to the best of my knowledge true and correct. 1 also certIfy that I am the owner or authOrIzed agent for the
ahove.mentlllned property and that all CllnstrUCtlon Will Cllnfllrm to all eXlstrng state and local laws and Will proceed in accordance with suhmltted plans. I am aware that the huildrng
~tiCial can revoke tl erm~~luse Furthermore. I herehy agree that the crty official or~~sr~Lm~ e;er 4P~le propel1y to perform needed i~pe:tD\s _ 0 .,
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
i Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Ilurldlllg UfIiclal
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water ConnectIOn Fee # $
Water Tower Fee # $
Builder's Deposit I $
Other $
$
ThIS IS to certify that the requl'st In the above applicatIOn and accompanymg documents IS m accordance with the City Zoning Ordmance and may procecd as requested ThiS document
when signed by the City Planner cnnstttutcs a temporal)' CertIficate of Zomng complIance and allows construction to commence Before occupancy, a Certificate of Occupancy must be
i.'islIcd
Planning Director
Special Conditions. if any
Date
24 honr notice for all inspections (952) ~47-91l50, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372