HomeMy WebLinkAboutBuilding 08-0205
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
1: 28,08
~. vz: ~~~ I PERMIT NO. 0 ~, 0 z. OS I
3. Yellow Applicant . .
I. ZONING'__l
p~.\~ ~ ('(IN 5531c1 .
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
OWNER
(Name) ( Y\E> \ \ ~ \-'\(1 (e.x\
(Address) \ 1311o
Lx 0. \~y e_
d p(l'~ fDt-.J ~la
(phone)qfA. - L\L\1- 14<1 \C)
BUILDER C . r '
(Company Name) (\{'(L.fY\} .:~:t:ef\O\5 I Lrc.,
(Contact Name) \~Y('\j Sf' }.J' ov.c:.on
(Address)
(phone) q~a-LlLj:1-~Lc)~<;<
(phone) )(')i;-i-dlQI -, l.tWd
[JRe-Siding OLower Level Finish 0 Fireplace
lYPE OF WORK 0 New constru~.on ODeck OPorch ORe-Roofing
OAddition ~Alteration OUtility Connection
CODE: OI.R.C. OI.B.C. 0 Mise:
Type of Construction: I n ill IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
PROJECT COST IV ALUE $ \) ~ L\ to . ()C)
(excluding land)
I hereby certifY that I have furnished infunnation on this application which is to lhe best of my knowledge true and correct. I also certifY that I am the owner or aulhorized agent fur lhe
above-mentioned property and that all construction will confurm to aU existing state and loclIllaws and will proceed in accordance wilh submitted plans. I am aware lhat the building
official can r 1his permit fur just cause. Furthermore, I hereby agree city official or a designee may enter upon lhe property to perfurm needed inspections.
X /~~
ignature .
mN d('A.'17~Ln
Contractor's License No.
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
SewerlWater Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
#
#
Permit Valuation
Permit Fee
Plan Check. Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
#
#
L\-cl~-(J~
Date
$
$
$
$
$
$
$
$
$ 7(,,00
This Application Becomes Yoar BaildiDl Permit When Approved
Buildill2 Official
Date
1bis is to certifY that the request in lhe above application and accompanying documents is in accordance with lhe City Zoning Ordinance and may proceed as requested, 1bis document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows consttuction to commence. Befure occupancy, a Certificate of Occupancy must be
issued.
Special Conditions, if any
Date
Planning Director