HomeMy WebLinkAboutBuilding 08-0466
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I White
Pink
Yello\\'
File
City
Applicant
I PERMIT NO. ~ - o4-f, ~ I
ZONING (office use)
./1dP /e
/
LEGAL DESCRIPTION (office use only)
/
7:Jt;
7/-
.)e.-
LOT
BLOCK
ADDITION
OWNER r:'
(N ame) L7 ('./ Y1. L.-
/1 ~ If (/1'1 .I t'~
(Address) / Y
5~
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplilce
OAdditlOn OAlteriltion o Utility ConnectIon
CODE: DI.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
o Mise.
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have hlrnishcd mformation un this application which IS to the hest of my knowledge true and cnrrect. I also certify that I am the owner Of iluthorIzed agent for the
,lhove-mentloned property and that all constructIon will conform to all eXlstmg state and local laws and will proceed m accordance with subml!ted plans I am aware that the bUlldmg
oflici'll can revoke tillS perml! for Just cause Fur rmore, I herehy agree that the City official or a deSignee may enter upon the propeJ1y to per!llfm needed mspectlons
X _~~ L.
Contractor's License No
7-/SI-.t1~
~
ecomes Your Building Permit When Approved
7hy}tfj
I 1);J1C
Paid
Date '/'y~
# $
# $
$
$
# $
# $
$
$
$ 7& C!e.
I ~~cei~o.S-u3?3
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
$
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 applicatIon and accompanymg documents is in Jccordance with the City Zoning Ordinance Jnd may procecd as requested ThiS document
when signed by the City Planner Cl1nstltutes a temporary Certificate of Zomng compliance and allows construction to commence. Before occupancy, il Certificate of Occupancy must be
Isslled
Planning Director
Date
24 hour notice for all inspections (952) ....7-9850, fax (952) 4"7-"245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any