HomeMy WebLinkAboutZoning Permit 06-0020
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 0 r..o - ;yo I
(Please type or print and si~ at bottom)
ADDRESS
ZONING (office use)
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LEGAL DESCRIPTION (otf1ce use only)
LOT
BLOCK
ADDITION
PID
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(Address)
(Phone) G,S-' - 4 ~O ~-1S4 s.-y
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
CODE: ~I.R.C. OI.B.C. D 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
ORe-Siding OLower Level Fimsh D Fireplace
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PROJECT COST/VALUE $ /
(excluding land)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
DAddition DAlteration DUtility ConnectIon
~
e best of my knowledge true and correct. I also certify that I am the owner or authOrized agent [or the
state and local law, and will proceed in accordance with submitted pfans I am aware that the buildmg
l we CIty ottlcial or a deSIgnee may enter upon the propel1y to perform need cd mspectlons
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/
#'
~rmit Valuation
Contractor's License No.
Date
Builder's Deposit
Other
# $
# $
$
$
# $
# $
$
~/ }(J $ ~/
/ I '-I~
Sewer & Water Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Gas Fireplace Permit Fee
TOTAL DUE
This Application Becomes Your Building Permit When Approved
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Paid
Date
Receipt No.
By
ThiS IS to certify that the request in the above applical10n and accompanying documents is 111 accordance WIth the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the CIty Planner constItutes a temporary Certificate of Zomng compliance and allows construction to commence. Before occupancy, a Ccrtltkatc 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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