HomeMy WebLinkAboutZoning Permit 05-0002
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
File
City
Applicant
PERMIT NO.
White
Pink
:\ Yellow
(Please
ADDRESS
/7/3
t4...../ i L VC/[- /1./':- :> --> "/72 L.
5- :-f-'
LEGAL DESCRIPTION (office use only)
LOT BLOCK ~ ADDITION
PID 7.5,- - ~ 70 -0 .(-6
OWNER
(Name)
(Phone)
G /;/ -, G Z I -- y: 73Y
/
JD/JrI
1 7/ 8 ,f
L.~
I, . L. Oc: /.: I.J : ~ 5
'P2-L
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(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
/=/;3"'/'1 (.i_ L.O
V,,;4N ~~? .::::' S5;'?-;?4-'V/
(Phone)
(Phone)
Date Rec' d
ZONING (office use)
d-
~/:2 _.
8 d!J- '13 k,.C
TYPE OF WORK ~New Construction DDeck OPorch ORe-Roofing
OAddition o Alteration DUtility Connection .3l Misc.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
ORe.Siding OLower Level Finish
FE-;/CG- 1{
PROJECT COST /V ALUE $
(excluding land)
o Fireplace
qlt-rA/U/V'1C-
26C:V. DC)
~
I hereby certl!y that 1 have furnished mformation on this application which is to the best of my knowledge true and cotTect. 1 also certify that I am the owner or authonzed agent for the
above.menuoned property and that all construction will conform to all exisltng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can rev(k<; thiS permit for Just cause Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the property to perform needed mspecltons.
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Signature Contractor's License No. Date
Permit Valuation
Park Support Fee
SAC
#
#
Permit Fee
$
$
$
$
$
$
Builder's Deposit
Other
Plan Check Fee
Water Meter Size 5/8"; I";
Pressure Reducer
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer/Water Connection Fee
#
#
Water Tower Fee
TOTAL DUE
Paid
Date
$
$
$
$
$
Receipt No.
By
ThlS tS to certify that the request m the above applicalton and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. TIllS document
when signed by the Cay Planner constttutes a temporaty Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a CerltflCate of 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