HomeMy WebLinkAboutBuilding Permit 08-0584
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
13 - () eEl
White
Pink
Yellow
[ PERMIT NO. 08 . o~e4---t
File
City
Applicant
ZONING (office use)
3=Z;/f-C
('t/!:?}L L (. C-;<-- -1).rc
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
;{Q,l
(Phone) "!{',:]
(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility ConnectIon
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
o Misc.
B
S
PROJECT COST IV ALUE
(excluding land)
$
U
I hereby certify tha I have hlrmshed Inf(lrmation on this applicatIOn whIch IS to the best of my knowledge true and correct. I also certIfy that I am the owner or atlthonzed agent tilr the
above-mentIOned, roperty and that all constru~on will conform to all existing state and local laws and will proceed in accordance with submIlled plans I am awa. re that the building
offiCIal can > thIS perml~~rcause Vtllthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propelty to perform needed inspectIOns
X :~.~. k/~ ~--' ;p /;e /;7
- Signature Contractor's License No. ' Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildlll!! Onicial
Date
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 IS to certify that the request in the above application and accompanYIng 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 Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certlticate of Occupancy mllst be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372