HomeMy WebLinkAboutShed Permit 07-06
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 J1
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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OWNER t::< ~,~
(Name) (~ {(( 1...X.>0'c-f-"\/
(Address) /6 ~ /11 5( /J? p lul'i3
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BUILDER .
(Company Name) EX.F(~u.-n cf F G~t;:/2j ()/<5
(Contact Name) /J:l/JI{ /L <; /5uJ ~P..5
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(Address)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAdditlOn OAlteration o Utility ConnectIon
I White
Pink
Yellow
File
City
Applicant
PERMIT NO. 0 7 0 O{; 0)
PID
Date Rec' d
(I. 4.6 1
ZONING (office use)
. (Phone)~/2-<R7f~~/1J
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(Phone)
(Phone) -7& '1 - ~~;r-- S"O_r2
?dJ-~CJ:f-(/99&
ORe-Siding OLower Level Finish
~1Led ~
CODE: DI.R.C. DI.B.c. lp..,M isc
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
PROJECT COST /V ALUE $
(excluding land)
o Fireplace
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I hereby certity Ihat I have hlfIllshed mformatllJn on this applicatllJn whIch IS to the best of my knowledge true and correct I also certify that I am the owner or authorIzed agent tm the
JbllVc-mcntlOned property an lilt all cDnstruction will confnrm to allexlstmg state and local laws and will proceed in accordance with submItted plans I am aware that the buildlOg
official can r 'voke thiS r Of .lust cause Furthermofe, I hereby agree that the CIty official or a deSIgnee may enter upon the propel1y to perform needed IOspectlon,'i
x
Park Support Fee
SAC
Signature
Contractor's License No.
Permit Fee $
Plan Check Fee $
#
#
$
$
$
I $
i $
$
$
/;$
11!NO
Pressure Reducer
Water Meter SizeS/8"; I";
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechamcal Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
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tjl-.e'/7
Paid
Date
#
#
Date
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$
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ThIS IS to/ertlfy thilt the request 1Il the above applicatlOn and accompanY1l1g documents IS III accordance with the City Zoning Ordinance and may proceed ,lS requested ThiS document
when signed by the CIty Planner constItutes a tempurary Certificate uf Zonll1g compliance and a11o\\'s constructIon to commence. Before occupancy, a Certificate of Occupancy must be
isslIed
Date
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