HomeMy WebLinkAboutBuilding Permit 09-0194
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5'~'1
File
Citv
Applicant
I PERMIT NO. 09. olr4J-
White
Pink
Yellow
(Please
ADDRESS
c./' .
s~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) '""f ol2& Co
~; \ r' !:. S c.. 2.Q.ll-~
,
ZONING (office use)
(Address)
~. ('c..-V I...
~J2
44 b- C:.O{ I
L,
...
(Phone)
BUILDER
(Company Name)
(Contact Name)
(Address)
~" ""-::> G\...~ C'~'!:o~
~h""- ~ L~O\.~o~
b~ ~ b "TrJ.
(P~qS-J.~~lfO'- '518S
(Phone)GJ. - q LJO- -, 105
l-.
.--:r:^~
s'B7
6'
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration o Utility ConnectIon
CODE: !.R.C. DI.B.c. o Mise. E&~eSS vV IN t>(W
Type of onstmction: I II III IV V A B k.Q::::t) t!:'< ;.--
PROJECT COST IV ALUE $ /
Ocropancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certify that f have tllrmshcd mformatIOn on this application which IS to the best of my knowledge true and correct. r also ccrtlty that I am the owner or authonzed agent for the
abl1vc-mentlLlned pm erty and that all constructllln will Cllnform to all eXIstIng state and local laws and will pmceed in accordance with submltted plans I am aware that the buildIng
~liCiUn rev ' th rmlt tilr J0~ agree that the CIty official or a deSlg~ g ~cr( upon the pmpelty to pert(llm 11l'~ I:pe.;': 09
Signature Contractor's License No, Date
Permit Valuation
Park Support Fee
SAC
-r.. 500- -
l~. 1-;-
#
#
Permit Fee
$
$
$
$
$
$
Builder's Deposit
Other
Plan Check Fee
Water Meter Size5/S"; I",
Pressure Reducer
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
(. "l..<,
Sewer/Water Connection Fee
#
#
Water Tower Fee
Sewer & Water Permit Fee
TOTAL DUE
$
$
$
$
$
$
$
$
$
'7 {,. (T(J
-4 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions. if any