HomeMy WebLinkAboutZoning Permit 05-0004CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS PIA 1 (& k
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
OWNER (1)... Wo2..„4cL
(Name)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ['Porch ❑Re -Roofing
❑Addition ['Alteration ['Utility Connection
CODE: R.C. ❑I.B.C.
Type of Lonstruction:
Occupancy Group:
Division:
I II HI
ABE F H
1 2
IV V A B
I MRSU
3 4 5
❑ Misc.
I Wh le File
2 Pink city
t yellow Applicant
(Phone)
(Phone)
(Phone)
Date Rec'd
/o.20.oj'
PERMIT NO. 0,5_ OA--
ZONING (office use)
PID 2S. d,/, 00.5. 0
❑Re -Siding Lower Level Finish
PROJECT COST/VALUE $
(excluding land)
Fireplace
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner of 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 budding
official can revoke this permit for lust cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections
/6/o/o Y
Signature Contractor's License No Date
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 Permit When Approved
to/Z4./oS
Building Official Date'
Park Support Fee
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
$
$
$
$
$
$
$
Im
Receipt PH
By 4 /,
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 iequested This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence Before occupancy, a Ceitificate 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
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Scott County
Page 1 of 1
This drawing is neither a legally recorded map nor a
survey and is not intended to be used as one. This
drawing is a compilation of records, information, and
data located in various city, county, and state offices,
and other sources affecting the area shown, and is to be
used for reference purposes only. Scott County is not
responsible for any inaccuracies herein contained. If
discrepeancies are found, please contact the Scott
County Surveyors Office.
/Scott
October 20, 2005
http://www.co. scott.mn.us/servlet/com. esri. esrimap. Esrimap?S erviceName=overview&ClientVer... 10/20/2005