HomeMy WebLinkAboutBuilding Permit 04-0602
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(Please
ADDRESS
at bottom)
White File I PERMI ~
P;nk C;ty T NO. /7 1/_ /-0
Yellow Applicant CL!L (p _
ZONING (office lIse)
/+,St,o
W / L-DS
P A K:4c:. N /tl/
Pu.sD
LEGAL DESCRIPTION (office use only)
LOT q BLOCK..3 ADDITION
7J-I c W / '-.os
PID 25. z.q,. 03/.0
OWNER
(Name)
/l1 eL V /11/ Moo /t..6
(Phone) (.;,5/, 33(,. B 7~ 7
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing )lrRe-Siding OLower Level finish 0 fireplace
OAddition OAlteration o Utility Connection 0 Misc.
CODE: OLR.C. OLB.C.
Type of Constntction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST /V ALUE $
(excluding land)
I hereby certify that I have furnished mformation on this applicatIon which is to the besl of my knowledge true and correct. I also certtfy that I am the owner or authonzed agent for the
above-mentIoned property and that all construction will con for . stIng state and local laws and will proceed in accordance with submitted plans I am aware that the bllildmg
Ilfficial can revoke this permIt for Just cau - hermor e agree tha the CIty official or a destgnee may enter lIpon the property to perform needed mspectIons
0(,,/ J 7 J 0'-1
I Dale
x
Contractor's License No
Permit Valuation 2 SOO.DO
Permit Fee $ 74. I'JS
Plan Check Fee $
State Surcharge $ .25
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
Sewer/Water Connection Fee
#
#
$
$
$
$
$
$
$
$
$ 7 cP. 00
Water Meter Size 5/8"; I";
Pressure Reducer
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
'~~;~)Lj
I ~~CiPt Ng0!, S-O
l3uildlll!! Official
Date
ThIS tS 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 constltutes a temporary Certificate of Zonmg compliance and allows constrllctlOn to commence. Before occupancy, a Certificate Ilf Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372