HomeMy WebLinkAboutBuilding Permit 04-1155
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
at bottom)
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LEGAL DESCRIPTION (office use only)
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LOT.?-BLOCK
I ADDITION
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White
Pink
Yellow
I PERMIT NO. otl-
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File
City
Applicant
ZONING (office use)
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(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing Re-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration DUtility Connection 0 Misc,
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
II
F
1
III IV V A
HIM R
2 3 4 5
I
E
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have f\Irnished mformation on this application which is to the best of my knowledge true and correCL I also certify that I am the owner or authOrized agent for the
above-mentIOned property and that all constructIOn will conform to all existmg state and local laws and will proceed in accordance with submittcd plans. I am aware that the buildmg
Ilftlcial can r k this perma for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the propelty to perform necded mspectmns.
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Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
13uildlll!! Ofticial
Date
() c - 201,", C\\ S S'
\ \ - \2. - \S
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
/
TOTAL DUE $ /}0, -
t!:'7; i
, ~,. -'1
I ~;ceiPtN~~ I
Paid
Date
ThIS IS to certify that the request in the above applicallon and accompanymg 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 Certlticate Df 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