HomeMy WebLinkAboutBUILDING 08-0210
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
4-- C/1,O/
File
City
Applicant
I PERMIT NO. ()(~ () 2/01
1 White
Pink
Yellow
n at bottom)
OVVl
c;r l- Ie
~I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(;5/
,
r fit l---,
~f ?/fd
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 FlrepLlCe
OAddition OAlteration o Utility ConnectIon
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A
Division:
o Mise.
$
f~6JC
V
M
4
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
ion ich is to the best of my knowledge true and correct. 1 also ccrtlty that I am the owner l)f authorIzed agent for the
ill conf 0 all eXIstIng state and local laws and will proceed In accordance with submItted plans I a aware thaI tl ' buildIng
ereby agree that the CIty official or a destgnee may enter upon the propeny to perttJrm needt I
x
Contractor's License No.
Permit Valu
Park Support Fee
SAC
#
Permit Fee
$
$
$
$
$
$
I $
$
TOTAL DUE
#
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; I",
Pressure Reducer
Sewer/Water Connection Fee
#
Sewer & Water Permit Fee
Water Tower Fee
Builder's Deposit
Other
#
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
Bulldll1g Ullielal
Dale
$
$
$
$
$
$
$
$
$
-
Thls IS to ccrtlfy that the request in the above applicatlon and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when Signed by the CIty Planner Cllnstltutes a temporary Certiticate llf Zllnmg complIance and allllws construction to commence. BettllT occupancy, a Certificate llf Occupancy must be
issued
Special Conditions, if any
Planning Direelor
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372