HomeMy WebLinkAboutZoning Permit 05-0001CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
¢308 1,9ss ?WeeT $
White File
2 Pink City
3 Yellow Applicant
Date Rec'd
PERMIT NO. 067 0 /
ZONING (office use)
R/siD
LEGAL DESCRIPTION (office use only)
LOT 'BLOCK ADDITION c$(/A/1-'/.$�f H 84 y PID 26. 0413. 003. 0
OWNER
(Name) DOUc f /1,D/C (Phone) 96Z. 44 0, 43/1
(14)952.82S.6975
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re -
❑Addition ❑Alteration ❑Utility Connection
ing ERe-Siding ❑Lower Level Finish ❑ Fireplace
Misc. oaeo K/ `smAi t/A/KI
CODE: ❑I.R.C. ❑I.B.C. PROJECT COST/VALUE $
Type of Construction: I II III IV V A B (excluding land)
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
I hereby certify that I have punished information on this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for the
above -mentioned property and that all onstructton 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 revok perm ..a. u c tse Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed ins pcent) gs.
Signature
i
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
13uildtng Official Date
Contractor's License No.
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 Receipt No.
Date By
to
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
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
w) * / /9 /oS
o
Planning Director r� — Dafe IrSpecialifonditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Valley Surveying Co., P.A.
16670 Franklin Trail SE Suite 230
Prior Lake, MN 55372
(952) 447-2570
INVOICE
Date: January 12`h, 2005
Doug Hadac
4308 Bass Street
Prior Lake, MN 55372
Project Number: 10022
Invoice Number: 10022
Work Description: Set/mark west line of Lot 5, SUNFISH BAY, Scott County, Minnesota.
Field Crew: 2.5hrs@$100.00 $250.00
Registered Surveyor: 2.0hrs@$70.00 $140.00
Drafting Services: 0.0hrs@$50.00 $00.00
Computations: O.Ohrs@$50.00 $00.00
Total Amount: $390.00
TOTAL AMOUNT DUE: $390.00
Thank you for choosing our firm.
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