HomeMy WebLinkAboutZoning Permit 05-0002
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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File
City
Applicant
Sfrc u '/ /z,() '-P'
PERMIT NO. 06-. () Z-
(Please type or print and sip;n at bottom)
ADDRESS
/5"970 {Aft-S7 /1'115
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2~;- /)+J_ 0/2-.0
OWNER
(Name)
_.,~
_J \.A~T..r AJ
\?-r: 11,' (l.. ':""""tl ,J
(Phone)
G \ ~d- - )., "3 7 - 1- '-I ).. s-
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition o Alteration OUtility Connection
ORe-Siding OLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.c. )?i Mise /1<!.-t!~.J C k~ tI t-I...N'i.
/
Type of Constmction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
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I hereby certify that I have hlfnrshed mformatlon on this applicatIOn which is to the best of my knowledge true and correct. [also certify that I am the owner or authonzed agent for the
above. mentIOned property and that all construction will conform to all eXlstmg state and local laws and will proceed m accordance with submitled plans, I am aware that the buildmg
oflicla] can revoke thl.~.7 .' ,mil for Just.,cause Furthermore, I hereby agree that the City official or a deSignee may enter upon the property to perform needed ms~eetll)~1S
X /d!--'72L-. s ,') . C' 5
/7' ~. / - Signature Contractor's License No. Date
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Permit Valuation
Park Support Fee
#
Sewer & Water Permit Fee
$
$
$
$
$
Sewer/Water Connection Fee
Water Tower Fee
#
#
$
$
$
$
$
$
r
I
In
1\ IL.
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Plan Check Fee
$
$
$
SAC
#
Permit Fee
Water Meter
Size 5/8"; I";
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Pressure Reducer
Builder's Deposit
Other
$
$
$
Gas Firep.lace PermifFee
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ThiS, caUJ.. . ',:..;'d;ngp=nWhtAr":
Ceo. ~/h/Os
BI~ldlng fliclal -'" I Dati
t
TOTAL DUE
Paid
Date
Receipt No.
By
ThIS IS to certIfy that the request In the above application and accompanymg docurnents is in accordance with the City Zoning Ordinance and may proceed as requested, ThIS document
when signed by the CIty Planner CIInstItutes a temporary Certificate of ZonIng cornplrance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any