HomeMy WebLinkAboutBuilding 08-0357
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
n at bottom)
-
,5 pr vC-e.
35eo
Date Rec 1 sl
&.~t.,(.y
1 White
Pink
Yellow
OJrJl
File
City
Applicant
PERMITNO.~.
j-;.
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
t!' Vc,.I 'J or (!....'-" Co n.J:r-r- vC- 'h' tJ h
~fJLS ~ '"
1-; 0 f2~ (nd> '\ d- -Av.JJ- S J_ -R."Lv (
(Phone)
(Phone)
fYlN
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{"Sl - ~~9-3/.?,-'}
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Conne
CODE: OI.R.C. OI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
IV V
I M
3 4
A
R
5
I
E
II
F
I
III
H
2
-Roofing ORe-Siding OLower Level Finish 0 Fireplace
o Mise.
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certity that I have turmshed InformatIOn lln thiS application which IS to the best of my knowledgc true and correct I alsll certrfy that I am the llwner or authol1zed agent tor the
ab"ve-mentwned property and that aU construction will cont()rm tll aU eXIStIng state and local laws and will proceed in accordance with submItted plans I am aware that the bUildIng
official can l"evl)ke thiS perffia for Just cause Furthermore, 1 hereby agree that the cay official or a deSIgnee may cnter upon the property to perform needed lnSpectllll1S
X ~~'7"// - ~o_S-V7Z <:::'6 0~'O~?
Signature . Contractor's License No. ' Date .
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee i $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $ i
This Application Becomes Your Building Permit When Approved
llulldlllg UI"flclal
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other
ThiS IS to certify that the request In the abdve application and accompanYlllg documents is In accordance with the City Zoning Ordinance and may proceed as requested ThiS document
\",hen signed by the CIty Pbnncr constItutes a temporary Certificate uf Zomng comphance and allo\\'s constructIOn to commence Before occupancy, a CcrtlticatL' of Occupancy must be
Issued
Planning Direclor
Special Conditions. if any
Date
24 hour notin' for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372