HomeMy WebLinkAboutBuilding Permit 09-0322
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
&,.11
I White
Pink
Yellow
I PERMIT NO. Ott. D3 Z-z.../
File
City
Applicant
.'
,
It:
ZONING (office use)
. ,/
~t:
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
'r:-/11 JlJtb ~
(Address)
(Phone)
tPl).,- 2D~-7~73
-
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch
OAdditIon OAlteration OUtility Conn
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV
I
3
V
M
4
ORe-Siding OLower Level Finish 0 Fireplace
o Mise
A
R
5
B
S U
PROJECT COST /V ALUE
(excluding land)
$
x
I hereby certify that I have hlrnlshed mt'Jrmation 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
abovc-mentIOned proper and that all construction will conform to all eXIsting state and local laws and will proceed in accordance with submItted plans_ I am aware that the buildmg
om I can revoke tIllS 'mil for ust cause Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propelty to perform needed inspections
tJ ~tf-D9
Date
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
Buildlllg Orticial
Date
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7(p. 0 d
1ft No
.57ff~
Paid
Date
~
(,. ,09
,
ThIS IS to certIfy that the request m the above application and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested Tlus document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence, Before occupancy. a Certlticate of Occupancy must be
isslIcd
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