HomeMy WebLinkAboutZoning Permit 06-0001
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I White
Pink
3 Yellow
File
City
Applicant
PERMIT NO. 00 -0 I
(Please type or print and sign at bottom)
ADDRESS
3HQ\ ~ \+1tOll CO\.1t:S jOt
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
K+\~L ~ l)FN <;E
112 E:-(VlVVl E:L-
(Phone)
qQ.. L~Llu '3Lll.-~
(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: OI.R.C. OI.B.C. o Mise.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
wk' ,:1
S H--~/)
PROJECT COST /V ALUE $_
(excluding land)
I hereby certify that I have hlrmshed mt()rmatlOn on this applicatton which IS to the best of my knowledge true and COlTect. I also certify that I am the owner or authOrIzed agent for the
above-menuoned property and that all construction will conform to all eXlstmg state and local laws and will proceed in aCClJrdance with submitted plans I am aware that the buildmg
';"'" "" '" " <",m" ,,, "'" "\:Jli:'mo". ] Oo"'" " " "" ",,'" oCr"", ," , ",,""" m" ,"" ""'" 'Oo "'''''''' '" ""'mm "1~"2"~"' - (J t,:>
Signature Contractor's License No. Date
Water Tower Fee
#
#
$
$
$
$
$ j
$ j
jljt) :OA~ /
$
$
$
$
$
$
$
f"
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Sewer & Water Permit Fee
Builder's Deposit
Other
TOTAL DUE
/ J
'YOU<B"d;n'~i~ZZ
--~ ~atc /
Paid
Date
Receipt No.
By
ThiS IS to cerufy that the request in the above applicatIOn and accompanymg documents IS m accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner C1Jnsututes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy. a Ceruficate of Occupancy must be
issued
Planning Director
Date
24 hour noticc for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any