HomeMy WebLinkAboutBUILDING 08-0828
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White File I PERMIT NO
; ~~~I~w ~~~Iicant . 0 B. 0 8 z..8
(Please type or print and sixn at bottom)
ADDRESS ,
V 2{/, Y C!)t'S/J7Vi c!-C~17 e ,4/ ~--,
LOT
BLOCK
LEGAL DESCRll'TION (office use only)
ADDITION
OWNER
(Name)
t:- IC!Jii/-c/' Vtf,1 1/ / /-e I-
~200/ C.!;c5InVTL'C:;}/7 e ,A/F
/
(Address)
ZONING (office use)
PID
(Phone) 95"c!">.2.:::;:'76, 2 tci c/_
L7 /, -1/1 555' 72
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BUILDER A 1 /J /:7 ,
(Company Name) . /v/L;--// C:C:/7,s'-/a'Ci' //C/7
(Contact Name) /C)/7 ~// ct C::'C)S-.5'/.r} cJf
(Address) $<555 '< /' ~J/)./} ~5 Ave j{;/{' 6.
752. ;;8;; - /2c;;(J
(Phone)
(Phone) cf5~'" L?S-5.
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TYPE OF WORK 0 New Construction ODeck OPorch ~-Roofmg me-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Conne~~~- r,
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc:
I
E
IT
F
1
ill IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $
(excluding land)
/u I (; 5
J
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 an 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 inspections.
X ~~ _ :;:2()/&, LIL( () 2 /6/ <] /c;rrJ
<; .;~~ . Contractor's License No. . Date .
------
I
I $
1$
1$
1$
1$
1$
1$
I $
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
, Gas Fireplace Permit Fee
, Park Support Fee
I SAC
I Water Meter Size 5/8"; )";
I Pressure Reducer
I SewerlWater Connection Fee
I Water Tower Fee
I
I
I TOTALDUE
#
#
#
#
Builder's Deposit
Other
r)
i /
I R ~feipt No.
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This Application Becomes Your Building Permit When Approved
Building Official
I Paid
Date
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If,)- J/.tJY
,
Date
1$
I $
j$
i $
1$
j$
1$
1$
1 $
fife -
j-z. 917
I
,
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 1
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.
Plannin~ 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