HomeMy WebLinkAboutBUILDING 07-1081
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I White
Pink
Yellow
File
City
Applicant
PERMIT NO. '7. lor/
(Please type or print and si~n at bottom)
ADDRESS
5?c 7~ CE>>;9Jev1/' (la P .s- (
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
(Phone)
(Address)
BUILDER J
(Company Name) ~'1I""-c.I! Cr~eJC
(Contact Name) (' O""'~1 6-r,,.~ okJ
(Address) III bit' (11$ +--L- Sf
Date Rec' d
//YrJ!
ZONING (office use)
(Phone) 7~ ~ - L/LfJ- 5S~ ii'
(Phone)
~<II .s ~
/-/-4 rr,'S mil
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Fimsh 0 Fireplace
OAddition OAlteration o Utility ConnectIon
CODE: DI.R.c. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Mise.
I
E
II
F
1
III
H
2
IV V
I M
3 4
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I have hlfmshed Information 0 this applicatIon which is to the best of my knowledge true and correct. I also certify that I am the owner or J.uthDnzed agent for the
,tlmye-mentlllned property and lat ,Ill Cllnstruct WIll contlJlm to allexlstmg stall' and local laws and will proceed in accordance with submilled plans I am aware lhat the bUlldmg
~liClalean re6tl11' perml J I,t cause lermore, I hereby agree that the CIty officia~ ~e6; ;Y;;;'"6IP''} property to pertllrm need; ;7;; tI 7
Signature Contractor's License No. - / 1\1te
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1",
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
.......... ,
I!.s?
11/,V~Ct I
V'
R4ipt No.
I By/./' .
t1
Paid
Date
Iluildlllg Ullicl<t1
Datc
$
$
$
$
$
$
$
$
$
A ,
'/ ~ (/t/
';-Tvv7
I
ThiS IS to certify that the request in the abllve applicatlOI1 and accompanymg documents IS m accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner ClH1StltUtCS a temporary Ccrtiticil{C of Zonmg compliance and allows construction to commence Befllre ()(cupancy, a Certificate l)f Occupancy must he
isslled
Planning Director
Date
2.t hOllr notice for all inspectiolls (952) ~~7-9850. fax (952) ~~7-~2~5
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any