HomeMy WebLinkAboutBuilding Prmit 09-0212
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
B 5-553
Date Rec' d
s.r.oi
(Please
ADDRESS
n at bottom)
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Pink
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I PERMIT NO. 09. 0 u 2J
File
City
Appl1cant
ZONING (office lIse)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
VAl
tv'l u n u E..12
(Address)
(Phone)
qs~ -M0- '-0387
Go(\~,:>n<.Lx::n D(\
BUILDER I \
(Company Name) W~M)..l6(2..Gup..(.I-O
(Contact Name) ~.le 1\
(Address) '5(04 I \vi i::.tJ) O{.2) AL. A:vr;
C:J- -t ( \ t.D 0... k:. (
(Phone) 051-4?J1-43';:).b
(Phone)
t;Sb6)-
I
('fin
N.
TYPE OF WORK 0 New Construction OOeck OPorch "5lRe-Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
OAddItlon OAlteration DUtihty Connedlon
CODE: DLR.C. DLB.C. o Mise
Type of Constmction: I II III IV V A B PROJECT COST IV ALUE $ " ;)-OC' DO
Occupancy Group: A B E F H I M R S U (excluding land) ~ ~':A..
Division: I 2 3 4 5
I hefeby certify that I have turmshcd mformation un this applicatIOn which is to the best uf my knowledge truc and correct I also certify that I am the ownLT or authOrized agent for the
abl1ve-mcntwned prl1peny and that all constrllctllJl1 will cLlnfurm to all cXlstmg state and local laws and will procccd m accordance With sllbmllled plans I am aware that the blllldmg
nftkial can rt'vokc thlS permit for Just calise Furthermorc, I hereby agrec that the City official or a deSIgnee may enter upon the propeI1y to perf(}rm needed lI1SpectHlns
X M - Cb-,~~a-- aOa~~'4'8~ 5/c;/b9
Signarure Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
i Penalty $
! .
i Plumbing Permit Fee $
frvrechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $ I
This Application Becomes Your Building Permit When Approved
Iluildlllg Urtlclal
Date
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1";
Pressure Reducer
SewerlWater Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
-
ThIS IS to certify that the requL'st in the abl}Ve applicatIOn and accompanY1l1g documents IS 111 accordance with the City Zlllling Ordinance and may pn}('ced as requested ThiS document
\\'hell signed hy the City Planner constItutes a tempor':lIY Certificate of Zonll1g complIance and allows constructlon to commence. Before occupancy, a Certificate of Occupancy mllst be
Issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (9:;2) 447-98:;0, fax (9:;2) 447-424:;
4646 Dakota Street Prior Lake, MN 55372