HomeMy WebLinkAboutbuilding 08-0901
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
ItJ, -U-"df"
] White
Pink
J Yellow
File
City
Applicant
I PERMIT NO. () f", 090/1
ZONING (office use)
~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
A.7). ~IIZ1l-Jy C~7\4tLJ~ I -::n>c.
,
.Ap:c>J2BJ J1'u ;.c.~,4-
c;, w:? S--!!t ~ ~ _
(Phone) ~/Z- .zO-19.?r--
(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAdditIon OAlteration OUtility ConnectIon
I hereby certily that I have hlrmshed Inr(lfmatlOn on this applicatIOn which is to the best of my knowledge true and correct. I also certlly that I am the owner Dr authonzed agent for the
above-mentlOned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
"fticial can revoke this pe 'mlt ~ s use Furthermore. I hereby agree that the CIty official or a deSIgnee may enter upon the property to perform needed mspectlons
-k. ~ ZD5/0f30(,?
Contractor's License No.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
x
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildlllg Ofliclal
Dale
o Fireplace
o Mise.
A
R
5
B
S
U
PROJECT COST IV ALUE $
(excluding land)
/O~~B
ate
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
$
ThIS IS to CCrIlly that the request m the above applicatIon and accompanymg documents is 10 accordance with the City Zoning Ordinance and may proceed as requested. Tim document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows constructIon to commence. Before occupancy. a CertIficate of Occupancy must bc
iSSlled
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372