HomeMy WebLinkAboutBuilding (Roof/Side) 09-0160
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
at bottom)
/,., ~
Date Rec' d
1. V:J/d;
White
Pink
Yellow
I PERMIT NO.OC; 6;t:o IJ I
File
City
Applicant
ZONING (office use)
A./ -E,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) ff&~ ~;"Ij,.
(Address) /.y f/
BUILDER
(Company Name) ~~f~VY'''
(Contact Name) ~; If I!:.
(Address) 9' '" t? tt:' ./ A
(Phone) ?.r.2... ~ 9 f.. s-' J
r r......,,"
~L..
rrr, y
/2,,~./r;,r
(Phone) 7 IS :1 -.5 ~/-p,) ~
(Phone)
"I
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TYPE OF WORK D New Construction DDeck DPorch ~e-Roofing ~e-Siding DLower Level Finish D Fireplace
DAddition DAlteration DUtility 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
D Misc.
B
S U
PROJECT COST IV ALUE
(excluding land)
$ /J1
7?1>
I hereby certity that I have hlrnlshed m!iJrmation 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 for the
above-menlioned property and that all construction Will conform to all eXlStmg state and local laws and will proceed in accordance with SlIbmlltcd plans. I am aware that the buildmg
official can revoke this permIt I' Dr Just calise Furthermore, I hereby agree that the CIty official or a deSignee may enter upon the propelty to perform needed mspeclions
X ~--~
~
~~.~
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 $
This Application Becomes Your Building Permit When Approved
13l1ildlll~ Otliclal
Date
2.t? /".s-.r.r ~ G
t:>~-~-D"
Contractor's License No. Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
$
ThiS IS to certify that the request m the above applicatIon and accompanymg documents IS in accordance with the City Zoning Ordinance and may proceed as requested Tim document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must 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