HomeMy WebLinkAboutZoning Permit 06-0005
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
8.2,0 (p
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City
Applicant
I PERMIT NO. 6&, U DO 51
J
(Please type or print and sign at bottom)
ADDRESS
1(P_r79 Lf~ ;eo~6
ZONING (office use)
S' - w-
9"Cdr 4fc.e.
,(,J
elJO
I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID z.~. IE. O/~7. D
(Address)
(j"cA ~
Ilo879
~~
Lt IIl.C RoQ.~
(Phone) , C?$l. W7.- flt{~
. .
OWNER
(N ame)
~UJ
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone) _
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofmg ORe-Siding OLower Level Finish 0 Fireplace
OAddition o Alteration OUtiJity ConnectIOn
I hereby certlly that I have furnished mformation on this application which IS to the best of my knowledge true and correct. I also certlly that I am the owner or authonzed agent for the
above-mentIoned property and that all constructIOn will conform to all existmg state and local laws and will proceed in accordance with submItted plans. I am "ware that the btllldmg
offiCIal can revoke thiS permIt for Just cause Furthermore, I hereby agree that the City official or a designee may enter upon the prope11y to perform needed mspecttons
I
E
II
F
1
III IV V
HIM
234
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
/;l(I/SI1e.d
I
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Mise
x
Signature
Contractor's License No
Date
Date
$
$
$
$
$
$
$
$
$
#
#
e, '2. O~
\ Park Support Fee
I SAC
\ Water Meter Size 5/8"; 1";
\ Pressure Reducer
\ Sewer/Water Connection Fee
\ Water Tower Fee
\ Builder's Deposit
\ Other
\ TOTAL DUE
\ Paid ----
I Date ~~. O&, -
-
#
#
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
--
e omes Your Building Permit When Approved
ThIS S to enttly that the request in the above applicatton and accompanying documents is m aecordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the CIty Planner ([lnstltutes a temporary Certifrcate of Zonmg compliance and allows construetton to commence. Before occupancy, a Certtfrcate of Occupancy must be
issucd
Special Conditions, if any
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372