HomeMy WebLinkAboutBuilding Permit 09-0216
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
s: II 01
File
City
Applicant
[ PERMIT NO. 0<( , Oz.../b I
] White
Pink
Yellow
~~
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
ZONING (office use)
OWNER
(Name)
Ie. I~~
(Phone) 95Z-l/l/7- g'7D c..
LI J\J~ #t
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
tU &:f7l-l) W. ~r C" ~ '"t. ::t:AJC
ViI I ~r: f?e=K..4-
1?E:bJ I~(,
(Phone) Ct rz - 5> ~ ~ - 38Z.3
(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Conne
ORe-Siding OLower Level Fimsh 0 Fireplace
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Mise.
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S
U
PROJECT COST/VALUE
(excluding land)
$
I hereby certify that I have hlrnlshed mformatlon on this apphcation which is to the best of my knowledge true and correct. I also certify that I am the owner or authOrized agent I," the
above-mentloned property and that al onstruction Will eonfillm to all eXlstrng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
ofticial can revoke thiS ermrt fo us aus' Furthermore. I hereby agree that the City official or a deSignee may enter upon the property to perform needed mspectlOos.
2o~ <?o/(,O/3 jW,Ify /1, 2o~ 7-
Contractor's License No. Date
Permit Valuation
Park Support Fee
SAC
Permit Fee
$
$
$
$
$
$
I $
$
Builder's Deposit
Other
Plan Check Fee
Water Meter Size 5/8"; I";
Pressure Reducer
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Sewer/Water Connection Fee
Water Tower Fee
This Application Becomes Your Building Permit When Approved
BlIlldlllg Ofticial
Date
#
#
#
#
$
$
$
$
$
$
$
$
$
ThIS IS to certify that the request m the above application and accompanyrng documents IS m accordance with the City Zoning Ordina and may proceed as requcsted Tim document
when signed by the Crty Planner CDnstItutcs a temporary Certificate of Zonrng compliance and allows construction to commence Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any