HomeMy WebLinkAboutBUILDING 08-0905
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
d v t1
I. Whi,e
2. Pink
J Yellow
[ PERMIT NO. OB ..'to ~. J
File
City
ApplicAm
~r
Pv (I.' V ~tt jLt
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER (J
(Name) 1'-,\ V\ 0\. ~
(Address)
~ \N{Vlt~y
(Phone) OJ) l ~ '> c1 \.f ' S f:J ) '"1
r ( e It- 14' V
~R (oV'\ 1Vt1 (n/~.., _
(Company Name) S p V I V\ ~ev t:::..Xt-ev Il) v(, I I LC
(Contact Name) bv VI \ :1 V b II\. j Xi1 '1
(Address) 17 6 ~i! V ifV Fl lL-- t2/
(Phone)
(~)
h'"'-'f
q ~L . Lf L-f () I ") (I 7
'1 I, 2- . 'i '1 ~. 11 C) 0
TYPE OF WORK 0 New Construction ODeck OPorch .~e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddilion OAlteration OUtility Connection 0 Misc.
CODE: ~.C, OI.B.C. PROJECT COST /V ALUE slDOIJ,OD
Type of Construction: I II ill IV V A B (excluding land)
Occupancy Group: A .B E F H I M R S U
Division: I 2 3 4 5
I hcreby certify lhall have furnished information on Ihis application which is to the best of my knowledge true and correCI. I also certify that J am the owner or authorized agent for the
above-menuoned property and that all ,construction will conform to all existing stare and local Jaws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke this p~for just cause. Furthermore, I hereby agree that the ciry officiaJ or a designee may enter upon the property to perform needed inspeCTions.
X -f;lfvi lArVL~ . 2-/JifO'L1 S If 10 .L0 ,-D0
Signa e Contractor's License No. Date
Permit Valuation -)--",,- /Y). ,.-
--
Permit Fee $ -U:-.."
Plan Check Fee $
State Surcharge $ \- ""2-,
Penalty $
Plumbing Permit Pee $
Mechanical Permit Pee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
- AppI' ... """"" y= ":W'''' Pmnit ~ r'
{O ~f>. ~
ate '
Park Support Pee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ tfo.-
I Paid
Date
7fr:J - ,
I of_e, /Df:6
,
I Receipt No. S-ro'17/
By ~14-
ThIS is to certify thallhe request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may prOCeed as reqUested. This documen!
when signed by the Ciry Planner constiturcs a remporary Certificare of Zoning compliance and allows construction ro commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions. if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372