HomeMy WebLinkAboutBuilding (meter) 07-0273
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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File
City
Applicant
PERMIT NO.~ 1" '2. -r 3
(Please type or print and si2l1 at bottom)
ADDRESS
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ZONING (office use)
(jZ.( S D
LEGAL DESCRIPTION (office use only)
LOT (BLOCK -S ADDITION
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,
PID 'l..S-447-0lt..-O
OWNER
(N ame)
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(Phone) Cy S' d- ""~'.fi' ""' 7' b ,+ 1
(Address)
Bun..DER~ \ ' ~ . \ / U - I .
(Company Name) d 01 ' _"L.l,,:~-? I__P &MJ
(ContactName)~\ ;'~1-j !.~)('-o.t1..) -
(Address)
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(Phone) ?b~-S"S'J ~7 9 0
(Phone) 'tSij . J.. t7 1(,;)..'1
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TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition OAlteration OUtility Connection 0 Misc.
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST/VALUE S
(excluding land)
I hereby certifY that I have tiJmished mformatIon on this application which is to the best of my knowledge true and correct. I also certIfY that I am the owner or authonzed agent for the
abov\mentIOned property and that all construction will conform to all eXlStmg state .and local laws and will proceed m accordance With submitted plans. I am aware that the buildmg
offici can revo thiS rmJt for US! cause Furthermore, I hereby agree that the City offiClal or a deSignee may enter upon the property to perform needed mspectlOns.
X , 9..: PT"\ C) CY3\'1)'1{ Ii" ~ ~-O /
(SIgnature Contractor's License No. Date
"-
Permit Valuation
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer/Water Connection Fee
#
#
$
$
$
$
$
$
$
$
$
I
I
<.J S-S-, 06
Park Support Fee
#
Gas Fireplace Pfrmit Fee "
l\ ,
Ii I.
~1;~'. ~rom:m '~'_P'~ ~~ r:~'d
811Id.l11~ ~ Date
----- ""'-
ThiS IS to certIfy that the requ"'t m the above apjj!itruon and accompanymg documents IS m accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when Signed by the City Planner conSI1tUles a temporary Certificate of Zonmg complianee and allows constructIon to commence Beton! Llccupancy, a Certificate Llf Occupancy must be
Issued
$
$
$
$
$
$
$
$
SAC
Water Meter Size 5/8"(1)
Pressure Reducer
#
Permit Fee
Sewer & Water Permit Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
4sC)-
Paid
Date
~.,;. s;
... ~. ~
4-~~~
'7' f
By
Receipt No. $"'2..4-(+
/l.A - .
, fI-
Planning Direclor
Date
24 hour notiee for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any