HomeMy WebLinkAboutBUILDING 08-0174
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
'l./~. Cl.r
(Please
ADDRESS
01
CANDy (' u~
1\GA1, L
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
1 White
Pink
,'ellow
File
City
Applicant
PERMIT NO. 0 r. 0 /7?-t
ZONING (office use)
\'\21 ~\C.
lA-lu-e
OWNER
(Name)
(Phone)
(Address)
i BUILDER
I (COmpanYName)~5J7t-""':Nln+ Ex,-
I (Contact Name) 6~~ /I<J>
I (Address) llUd-\ hJ\t---PU\N\ (Le{..se ()K.\il)L ~
(Phone) ~-od-<9 -113 J
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlon OAlteration OUtility ConnectIon
CODE: OLR.C. OLB.C.
Type of ConstIuction:
Occupancy Group: A B
Division:
IV V
I M
3 4
A
R
5
II
F
I
III
H
2
I
E
o Mise.
B
S
$
PROJECT COST/VALUE
(excluding land)
U
I hereby certity that I have turnIshed InformatIOn on thIS application which IS to the best of my knowledge true and wrrec! I also certIfy that I am the owner or authOrIzed agent t,)r the
aonvc-mcnt cd property and that all construction wlII conform to allexistmg state and local laws and will proceed in accordance with submitted plans_ I am aware that the building
()fflcial yoke thiS permIt for Just cause Furthermore, I hereby agree that the CIty official or a deSignee may enter upon the propel1y to perform needed mspcctHlns
~
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
Mechamcal Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
This Application Becomes Your Building Permit When Approved
llulldlllg Unlclal
Datc
Contractor's License No.
<7-7)-(j ~
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit I $
Other $ --1/
-
TOTAL DUE $ / u?
ThIS IS to certify that the requl'st In the above application and accompanYing documents is 1t1 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City PIilnncr Clll1stItutes a temporary Certificate of ZOlllllg compliance and allows construction to commence Before llccupancy, a Certificate of Occupancy must be
issued
Planning Direetor
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