HomeMy WebLinkAboutZoning Permit 06-0018
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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(Please type or print and si?;n at bottom)
ADDRESS
53&0
White
Pink
Yellow
File
City
Applicant
(!//ND'I ~tJ6 772rl1l-
LEGAL DESCRIPTION (office use only)
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ADDITION
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OWNER
(Name)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
Date Rec' d
5.31. OIP
I PERMIT NO. 0". (; 01 r I
ZONING (office lIse)
J2/~O
PID 25. OZ--7. Odf-, a
(Phone) $) - '!fo.-dl" 5/
(Phone) _
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition o Alteration OUtility ConnectIon
CODE: rv1I.R.C. DI.B.C. ~sc
Type of ~nstmction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding OLower Level FinIsh 0 Firep!ace p t'tiAc.-u1 ~ t)
r _ n -- e..c rl o.c...e.. C~i" I,., t( "- t-,t 6 1-5 (J
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PROJECT COST /V ALUE $ ;;2 r~ f I '-17/( n ~ ~
(excluding land) ~ .
I herehy certify that [ have hlrmshed mformation on this application which 15 to the best of my knowledge true and correct. I also Ccrtlfy that I am the owner or <1uthonzed agent for the
,lhl1VC-mentlllned property and that all construction will confurm tu all extstmg state and local laws and will proceed in accordance with submitted plans I am aware that the huildmg
"tflCl;1l can revoke tillS permIt for Just cause Furthermore, I herehy agree that the CIty official or a deSIgnee may enter upon the propeny to perform needed mspectlllns
x
Signature
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Contractor's License No.
$
$
$
$
$
$
$
$
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
--
Paid
Date
~
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Huildlng Orflclal Date
Date
# $
# $
$
$
# $
# $ '0
$ ~~
$
$
ReceiPt N~
By
---
TillS is to certify that the request m the ahove applicatIon and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested TIllS document
\\'hCI1 signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a CCI"uficatc of Occupancy mllst 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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