HomeMy WebLinkAboutBUILDING 08-0590
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
4-790
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Date Rec' d
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I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. C f (,57 c1
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
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(Phone)
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(Address)
TYPE OF WORK 0 New Construction ODeck <I.r ORe-Roofing
DAdditlOn o Alteration o Utility ConnectIOn
:), 1- (,2 (. ~3
Re-Siding DLower Level Finish 0 Fireplace
CODE: OLR.C. OLB.C. o Misc.
Type of Construction: I II III IV V A B PROJECT COST /V ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certify that I have furnished mformatlOn on this application which IS to the best of my knowledge true and correct. I also certlty that I am the owner or authOrIzed agent for the
above.mentlLlned property and that all CllnstrUCt!on will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
official can revoke thiS Perqllt for Jl~~ cause Fl~rmore, I hereby ag!3'e that the CIty official or a deSIgnee may enter upon the propelty to perform nee~ed mspecttons
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/ Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
l3uildllH! Orticlal
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
ThiS IS to certify that the request in the above applicatIon and accompanying 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 Certificate of Zonmg compliance and allows CllnstrUCt!on to commence Befme occupancy, a Certlticate of Occupancy must be
issued
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
Water Tower Fee
Builder's Deposit
Other
#
TOTAL DUE
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Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake. MN 55372
Special Conditions, if any