HomeMy WebLinkAboutBuilding 08-0834
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(please
ADDRESS
1 While
2. Pink
3. Yello\\
File
CII\
Applicant
I PERMIT NO. 08.0834t-
35 ~ :L[6VULJ *. /71 (
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
Pill
]
I
~~~(&,lel1 IliViw
(Address) - IS' J/ f {{.{j , 1/- ( -
~c~~~~Name)~Cl()~i0(&(:fi1:~eS-f 1&4. lIeu/ fltQS
(Contact Name) I ex;:! ~A,-, i( 17 (phone)
(Address) SZ-:7 ~A 0LC}f) !jf. GJ. ~' C)td-tf 1(jJ I ::lJUz} i
(Phone)
Y5/_1jL('}- /7L;&
(phone)
U IZ.32S-- 5!:rXJ
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc:
I
E
II
F
1
ill IV V A
HIM R
2 3 4 5
B
S U
PROJECTCOST/VALUE $
(excluding land)
(I 000 ' CD
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
above-mentioned property and that all oonstruction will oonform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke ~~~~ for lust ~re. I hereby agree that the city official O~deSlgnee ~ay :nte~ upon the property to perform needed inspecnons.
X ---- ~(~ (uul(/55, lollu/uS
I 19nature '- "- ~ Contractor's LIcense No. 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 $
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
Buildin!! Official
Date
TOTAL DUE
This Application Becomes Your Building Permit When Approved
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to 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
4646 Dakota Street S.E.. Prior Lake, Minnesota 55372