HomeMy WebLinkAboutBuilding 08-0541
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
I~or, ~
Co.trobr1ajc.. Cr.
Dut~ R~{!' d
'7 ,,~ t/ t/
. I/, 1;1"
I White
Pink
Yellow
I PERMIT NO. (J 3. 05'4-/1
File
City
Applicant
ZONING (office use)
LEGAL DESCRIPTION~office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name) 6vc..<'1Y.4-e-r. u"sl.
(Contact Name) 13 YYG.G- 12~~"
(Address) 'Y -Z-o (2'-,,,,,,,,,.sf 7ft.--
(Phone) (~s..,) ...2.~'-3"/3c)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
DAdditlon DAlteration o Utility ConnectIon
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
OLower Level Finish 0 Fireplace
o Mise.
B
S
PROJECT COST/VALVE
(excluding land)
$
V
I hcreby certity thaI I have hlrmshed mformatIl1n on this application which is to the best of my knowledgc true and correct. I atso certify that I am the owner or authOrIzed agent rtJr the
above-mentwned property and that aL Cllnstruction WIll Cllnform to all eXistIng state and local laws and WIll proceed in accmdance with submItted plans. I am aware that the buildIng
official can revoke thIS permIt ti)r Just cause Furthermore. I hereby agree that the City official or a designee may enter upon the propelty to perform needed InspectIons
x
~-~_/
Signature
7/.:2-9/08
Date
Contractor's License No.
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildlllg Ol1icial
Date
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE
ThiS IS to certify that the request in the above applicatlon and accompanYing documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner ClmS:ltutes a temporary Certificate of ZonIng compliance and allows construction to commence Before occupancy, a CertIficate of Occupancy must be
issued
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