HomeMy WebLinkAboutBUILDING 08-0136
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
n at bottom)
b~~y /?
t:Jd f..Y
Date Rec' d
f 3, tJr
1 White
Pink
Yellow
I PERMIT NO. ~. 0/3 h I
File
City
Applicant
/rd//
ZONING (office lIse)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
U4/S
(Address)
i BUILDER --f ~
I (Company Name) , . , ~
i (Contact Name) -tP /) ('~ / c.L
(Address) ~/oo U/I"'te ,g J I'd
//c4 /
q5;;; -~d/~ -~/d.;L I
(Phone)
(Phone) (cu- fd-3- io~
(Phone) '1 9-1JS- 7.?c:J&
J S'5-~~~
5/ ,levU /ik/~
I TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
o AdclitlOn OAlteration OUtility Connection
CODE: OLR.C. OLB.C.
Type of Constmction:
Occupancy Group:
Division:
I
E
II
F
I
III
H
2
IV
I
3
V
M
4
A
R
5
A
B
U
x
I hereby certify that I have hlrmshed mfmmatlon un this apphcatllln which is tu the best uf my knuwledge true and correct. I alsu certify that I am the uwner or allthumed agent 1\11 the
abuve-mentluned property nd that ClInst 'lIctllln Will confurm tu all eXlstmg state and lucallaws and will proceed m accordance with submitted plans I am aware that the bUlldmg
official can revllKe thiS per It for st aus urthermorc, I hereby agree that the city official or a deSIgnee may enter upon the propeI1y to perform needed tnspectlolls
~/Ogv ___
Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $ i
This Application Becomes Your Building Permit When Approved
llurldll1g Ortlcial
Datc
ORe-Siding
OLower Level Fimsh
o FIreplace
B
S
;BJ"Misc K-r:f-Jlc;('fl /3 /J1/JdJ/u.s
iPcJ
PROJECT COST IV ALUE $ :; '17,5-:'-
(excluding land)
/c>:5-~
Contractor's License No
Park Support Fee
SAC
#
#
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fec #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE
'7&,,() 0
ThiS IS to certify that the request 111 the above applicatlDll and. accompanYll1g documents is 111 accordance with the City Znning Ordinance and may proceed as requcsted ThiS document
whcn sign cd by the CIty Planner constitutes a tempurary Certificate of ZOl1lng compliance and allows cunstructlOn to cummence Before occupancy, a Certlllcate l)f Occupancy mllst be
issllcd
Planning Director
Special Conditions. if any
Date
2.. honr notice for all inspections (952) ....7-9!l50. fax (952) ....7-..245
4646 Dakota Street Prior Lake, MN 55372