HomeMy WebLinkAboutBUILDING 08-0827
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White File
2. Pink City
3. Yellow Applicant
I PERMIT NO. 08 . 0 e 2..1
I
/ rQ//
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
/~" (A/T' (3 (' /; /) e e tu //1 cl
/7 /Ofv WI. /d t r () ~5-S Tr~t'l J
(Phone) 952- 2 '-/0 52S&;
jJ/'/ ~J/ i C1)?e J1 AI .5.5 372
'"
(Address)
,
(Phone) (Iv:2.,y ~ g .
(Phone) 952
/V! tI .3 5 '3 J
i 2 cJ()
2.53' ~/&{)S'
BUILDER J1 All r) .
(Company Name).LJ.LJ~ .!t;'
(Contact Name) 'Ton
(Address) q,'5 55 "
.L 11<2.
TYPE OF WORK 0 New Construction ODeck OPorch ~e-Roofmg ORe-Siding OLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connectlon
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc:
I :); IlGL-
B
S U
ill IV V A
HIM R
2 3 4 5
II
F
1
I
E
PROJECT COST IV ALUE $
(excluding land)
I hereby certiJy that I have furnished information on this application which is to the best of my knowledge true and correct. I also certiJy that I am the owner or authorized agent for the
above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspecti s.
X 9-C/(14L/CJ-, It) g
<;ignature Contractor's License No. Date
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Buildinl! Official
Date
$
$
$
$
$
$
$
$
$
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
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