HomeMy WebLinkAboutBuilding 08-0342
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
r;J 9. of
(Please
ADDRESS
1 White
Pink
\'ellow
I PERMIT NO. 08, 034-L
File
City
Applicant
ZONING (office use)
499/
6eJ7r!H
~r
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
I hereby certify that I have hlfmshcd mformatlOTI un this applicatIon which IS to the best of my knowledge true and correct. 1 also certify that I am the owner or authonzed agent for the
abl1ve-mentlllned property and that all constructllln w1l1 cl1nform tl1 all eXlstmg state and Il1callaws and will proceed in accordance with submitted plans I am aware that the buildmg
I1ffiClal C - , tillS permit t(,r lust cause Furthermore, I hereby agree that the City I1fflcial or a deSignee may enter upl1n the propel1y tl1 pert(lrm needed mspectll1nS
- (j\-- ,;l.0317Cj -;S- (; -CJ;-() if
Contractor's License No.
(Address)
TYPE OF WORK 0 New Construction ODeck OPorch
OAdditlOn OAlteration OUtility Connec
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
IV
I
3
V
M
4
A
R
5
II
F
I
III
H
2
I
E
x
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
i Penalty $
I
I Plumbing Permit Fee $
,
Mechal11cal Permit Fee $ i
Sewer & Water Permit Fee I $ I
I
Gas Fireplace Permit Fee =1 $
This Application Becomes Your Building Permit When Approved
Date
Iluildlllg OftlClal
]:'J1 <0
(Phone) ~ / ;? - 9~ 1- ?: C/~ 5---
(Phone)
~~O (I <..
. J11 J,U
ORe-Siding OLower Level FinIsh 0 Fireplace
o Mise.
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
Park Support Fee
SAC
#
#
Date
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE
ThiS IS to certify that the request 111 the above applicatlon and accompanymg documents is 111 accordance WIth the City Zoning Ordinance and may pnlcl'l'd as requested ThiS dllcumcnt
when signed hy the City Planner constItutes a temporary Certificate llf Zonmg cllmphance and allows constrUCtlon to commence Befllre occupancy, a Ccrtlticate I1r Occupancy must be
isslled
Planning Director
Special Conditions. if any
Date
24 hOUf notice fOf all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372