HomeMy WebLinkAboutShed Permit 07-03
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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Applicant
(Please type or print and si~n at bottom)
ADDRESS
40:11
M~U
e4
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
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Dilte Rec'd
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PERMIT NO. tJ 7- 0003
ZONING (office use)
PID
(Phone) 6 {/2,-74-3-- f1>ou
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK D New Construction DDeck DPorch DRe,Roofing
DAddition DAlteration DUtility ConnectIon
~- (0' v... lD'
DRe,Siding DLower Level FinIsh D Fireplace
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CODE: \a'f.R.C. DI.B.c.
Type oj't6hstmction: .
Occupancy Group: A B
Division:
~Misc
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hefeby certity that I have furnished mfnrmation on this applicatIOn which IS to the best of my knowledge true and correct I also certify that I am the owner or authonzed agent for the
JhllVC-mcnllOocd property and that all construction will confor ) allexistll1g state and local laws and will proceed in accordance with submItted plans. I am aware that the building
~rlClal can revuke tillS per ell' y agree that the City offiCial or a deSIgnee may enter upon the plopeny to peltorm needed IllFlq (D l
~ Contractor's LICense No bate
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
MechanIcal Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
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
This Application Becomes Y 2ur Building Permit When Approved
Paid
Date
~~
5h/~7
I Itlatc
lllllldlll~ Umcial
# I $
# I $
I $
I $
# ! $
# I $ f)
$ --
$-- V
$
Receipt No.
By
ThIS IS to certify that the n:qucst in the above applicatIOn and Jccompanymg documents IS in accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner constitutes a temporary CertIficate of Zoning compl1ancc and allows construction to commence. Bcfure OCCUPill1CY, a Certlticatc ()f Occupancy must be
Isslled
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any