HomeMy WebLinkAboutBuilding Permit 09-0085
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
:J (11
n at bottom)
ADDRESS
~
L- I ~-' U',
I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
White
Pink
Yellow
File
Cily
Applicant
I PERMIT NO. 09 0 0851
ZONING (omce use)
OWNER
(Name)
(Phone)
(Address)
BUILDER /J 'I..../J..- \
(COmpanYName)~~/f.'n\,...., A+'ur~...1. J ~~~'./'
(Contact Name) J ,.......... <- I ~ ~oe' ,~_
(Address) .-.-S:
(Phone) q -S..:2 8:.'f6 -~
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Conn
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
IV
I
3
V
M
4
A
R
5
II
F
1
III
H
2
I
E
ORe-Siding OLower Level Finish 0 Fireplace
o Mise,
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certity that I have hlrnrshed I 'ormatIon on this applIcation which is to the best of my knowledge true and correct. I also cerlify that I am the owner or autho!lzed agent for the
above-mentIOned roperty and lat I aonstructlOn will conform to all eXlstmg state and local laws and WIll proceed in accordance with submllted plans I am aware that the buildmg
1r JU c 'Ise Furthermore, I hereby agree that the City official or a deSIgnee may enter upon the propelty to perform needed mspectlOns,
J!!/
ignature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Date
Build1l1!! Ortleial
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 $
ThIS 1S to certify that the request in the above applicatIOn and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested TillS document
when signed by the CIty Planner constItutes a temporary Certiticate of Zonmg compltance and allows constructIon to commence Before occupancy, a CertIticate of Occupancy must be
isslIcd
Planning Director
Special Conditions, if any
Date
24 honr notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372