HomeMy WebLinkAboutPatio Permit 08-0028
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(,. 2fA,. 08
I White
Pin"
Yellow
File
City
Applicant
(Please type or print and sign at bottom)
\ 'ADDRESS .
1" /6077 A/oRT:J-)lU&O~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
~
OWNER
(Name)
,JoE /#S~OF~.?<6
::5.h'/o/E
(Address)
i BUILDER
(Company Name)
(Contact Name)
(Address)
~/}
(PhOn~
(Phone)
(Phone)
PERMIT NO. OB, OOZ/)
ZONING (office use)
PID
~ ~~ -'-I ~o...6 3 ~i.}
TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing
OAddition OAlteration o Utility Connectlon
ORe-Siding OLower Level FinIsh
(t?' -I
I) ~ (':, CDAJC/I...., <t6'
S"'.:.A6
CODE: DI.R.c. DI.B.c. o Mise.
Type of Constmction: 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
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
I hercby certify that I have turmshcd mfnrmatlOI1 on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authOrized agent flH" the
above-mentlllned propcrty and that all eonstructlon Will conl"rm to all eXlsung state and local laws and Will procced III accordancc with \ubmlttcd plans, I am aware that thc bllIldlllg
'X,ltiU'1l can ~1IS pc'mlt 1m ~ ause FlIIthelmOle I heleby agree that the City offiCial or ,I deSignee may enter upon the plopenv to pClfmm nCCdC';Pcct":'/..;:? _ of
~~ ~
- ~ SIgnature Contractor's Ltcense No D<lte
Permit Valuation
Permit Fee
$
$
$
Plan Check Fee
State Surcharge
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water PerF it Fee $
Gas Fir)Pjace pe:ftt Fee ~. <t .
/1 /I / I /
pH ~o., "wldi., P''''"'J AP7d~
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-- -
Park Support Fee
SAC
Water Meter Size5/S"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
# $
# $
$
$
# $
# $ \
$
$ f'
$ \" l I
ReceiPt No.
By
ThiS IS to certify th,lt the request 1I1 the abl)Vl' appl1catlon and accompanYlllg documents is 111 accordance with the City Zoning Ordinance and may prllcl'cd as requested ThiS document
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,/ / .r PljlIl'fiing Director Date Special Conditions. if any tJ~M 'f;,1
24 hOllr notice for all inspections (952) 447-9850, fax (952) 447.4245 i -, I
4646 Dakota Street Prior Lake, MN 55372
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