HomeMy WebLinkAboutBuilding 08-0919
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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5 r-:- sf
1 White
Pink
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File
City
Applicant
PERMIT NO. t.
7/7
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
OWNER
(Name)
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(Address)
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BUILDER
(Company Name)
(Phone)
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(Contact Name)
(Address)
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(Phone)
(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe.Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: DI.R.c. DI.B.c. o Misc.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $ 7/ Ef-;'u
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5 (excluding land)
I hereby certify that I have h.lrnished mformation on this application which IS to the best of my knowledge true and correct. I alsu certify that I am the owner or authorIzed agent for the
above.menlloned propcrry and that all construction will conform to all existmg state and local laws and will proceed m accordance with submitted plans. I am aware that the buildmg
omcial can revoke tlus permit for Just cause Furthermore, I hereby agree that the Clry official or a deSignee may enter upon the propelty to perform needed mspcctlons
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Signature
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Contractor's License No.
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Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes You~Building Permit When Approved
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ate
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7A'.C/C/
Receipt No, {6"Y 8"2
By ,C
Paid
Date
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ThiS IS to certify that the requcst m the above applicatIOn and accompanymg documents is m accordance with thc City Zoning Ordinance and may procecd as requested. ThIS document
when signed by the City Planner con:~tltutcs a temporary Certificate of Zonmg compliance and allows constructIOn to commence. Before occupancy, a Certificate of Occupancy must be
issued
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