HomeMy WebLinkAboutBuilding Permit 09-0215
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
Yellow
I PERMIT NO.
Date Rec' d
5' ~1l.0i
r - Z \5 I
File
City
Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
B \- l "-
~
cV\..'~~ (.1
~ k~.I"..Q
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
CS Q Ii'r-:;\ r) ~ h::>S:.
~LA. 6L1'c;l~
\I'-- Sf-_
(Phone)
C"/S2-rQ()
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l-l-o ~C
q ,) 2. - 7,,'2---2 ~yz
<{::)-2 -21"(.) - -"3 t:?6
(Phone)
(Phone)
M-6-J
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration o Utility ConnectlOn
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group:
Division:
IV
I
3
V
M
4
I
E
II
F
I
III
H
2
A
B
ORe-Siding
OLower Level Finish
o Fireplace
A
R
5
~isc Y€r-t1 J r--\.....
PROJECT COST /V ALUE
(excluding land)
$ ~ I{>(}j
B
S U
I hereby certify that 1 have furnIshed In!()rmation on this application which IS to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
above-mentIOned property and that all constructIOn Will cont(Jrm to all eXlSl1ng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildrng
officia evoke thiS permIt for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed rns ectllln.
X Oc..)()/IISo'--
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
$
(
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ ~f'5t.,
Paid
Date
I ~~ce1tfo. S7~ z..
ThIS IS to certify that the request rn the above applical10n and accompanyrng documents is rn accordance With the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the City Planner constItutes a temporary Certificate of Zonrng 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
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS /&c3SO PI1~ RVb
TYPE OF WORK Pel2-6; 0 LA"t
USE OF BUILDING /U5s ~/L---'
PERMIT NO. . CfJ 02-1 G DATE ISSUED 6. II. 09
BUILDER c;6fZ.tJ LO B/ZoS. PHONE # 7b~. 28 +z.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTO~ DATE
I FOOTING +- riElS. I eo#/ I 5". II" 07
. PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
IJIP'" I I
I FINAL I ~ ~1
FOR ALL INSPECTIONS (952) 447-9850