HomeMy WebLinkAboutBuilding 08-0471
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
'-2 <6~~
~PR~M;- LIJt<F-
Date Rec' d
White
Pink
Yellow
I PERMIT NO. ~ . 4.:Il-J
File
City
Applicant
ZONING (office use)
~D.
. ..
LEGAL DESCRIPTION~office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) L.rI1JDl\ lA )J:./ ~ 'i"'1'7.-n ~
(Address)
(Phone(jO?) ZZ<1J - 3 ~2 ~
BUILDER /1 /?
(Company Name) L-/~/Ja {~~T.
(Contact Name) ~~.&.., ~t-'UQI 1;:... 5.,
<?
(Address) 15~ .v
~J'
(PhOn')~S <0~1~~?-~
(Phone) 10 . - . d;
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAdditlon OAlteration OUtility ConnectIon
o Flrepl,lce
Re-Siding OLower Level Finish
~I
9~~
'/ I
I
CODE: OLR.C. OLB.C. o Mise.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $
Ocrupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certity that I have turI1lshed Information on this applicatIOn which IS to the best of my knowledge true and correct. I also certify that I am the owner III iluthollzed agent t"r the
JbOVC-mentlOned property and that all construction will conform to all existmg state and local laws and will proceed in Jccordance with submitted plans I am aware that the building
~EClal can revoke th ermlt r.,r II ,e F e,' 'by agree that the Clty~ficia~e~~;;; propeny to pertilrm nel0;<l~_
Contractor's License No. Date
Permit Valuation -;z...S-c9G> . -
Permit Fee $ '1 <\
Plan Check Fee $
State Surcharge $ L"'2-S"""
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit F;e $
proved
IClal /
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water ConnectIOn Fee # $
Water Tower Fee # $
Builder's Deposit I $
Other $
TOTAL DUE $ (~. -
r,!,;r 08
I Receipt No. ~3~
By M.
Paid
Date
ThiS lS to Ct.Ttlfy that the request In the above applicatlOn and accompanymg documents is 111 accordance with the City Zoning Ordinance and may procced as requcsted ThiS document
when signed by the Cily Planner con'tltlltes a temporary Ccrtiticate of Zonmg compliance and altllws l'LlJ1strllCtlon to commence. Befme llccllpancy, a Certlticate of Occupancy must be
Issllcd
Planning Director
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