HomeMy WebLinkAboutBldg Permit (h20 meter) 08-0154
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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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File
City
Applicant
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BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
i BUILDER
(Company Name) BO'C',......_J
(Contact Name)
(Address)
(Phone)
Date Rec' d
~,9: 06
PERMIT NO. 08. 0/ 54r
ZONING (office use)
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(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration o Utility ConnectIon
CODE: OLR.C. OLB.C. )(MiSC
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
ORe-Siding OLower Level FinIsh 0 Fireplace __
~ 0 1'1>0-\ bit' - t\1"~'l.--~
PROJECT COST/VALUE $
(excluding land)
I l]Creby certity that I have turnlShed 1nt()JmatlllO on this applical10n which IS to the best ot my knowledge true and CDlTec!. I also certify that I am the owner or authollzed agent t()J the
abovc-mentlOned property and that ,Ill constructwn will cont(Jrm to all eXisting state and local laws and will proceed In accordance with sub milled plans I am aware that the building
()tliciaI CJn revoke thiS permit for Just CJUSC Furthermore, I hereby agree that the Dty official or a deSignee may enter upon the propelty to pertc.)fm needed lnSpcctlOllS
8~
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Signature
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Contractor's License No.
$
$
$
$
$
$
i $
I $
Park Support Fee
SAC
Water Meter
,---....,
Si~";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Huildln~ Of/iCtal
Paid
Date
.s2.-~. () 0
4-,9 Or)
I
Date
y.q-oi
Date
# $
# $
$
$
# $
# $ I
$ j
$ 32.8. Of) 1
/1 $
Reo.uft No. $)57
By/ " /
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ThIS 1.\ to certify tl1Jt the requL'st 111 the abuve applicatiOn and accompanymg documents IS 111 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signetj by the Cay Planner COl1Sl1tutes a temporary Certificate uf Zunll1g complrance and allows constructllln to cummence Before lIceupancy. a Cerllticate lIf Occupancy must he
issued
Planning Director
Date
24 hOllr notice for all inspections (()52) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any