HomeMy WebLinkAboutBuilding Permit 09-0398
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/!c/v~ rJ- 6
Af,;'
White
Pink
Yel10w
File
City
Applicant
I PERMIT NOq . 5t8
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
;;z p~ /a.-t! /
f:v'f 1-10.4- .'1 f (-I N b
(Address)
(Phone)
U-1.. ~,f Li~ (
BUILDER
(Company Name)
(Contact Name)
(Address) 1"1
(Phone) q S"""...? ,~t:./<.' .- ~;X.;)....
(Phone)
pIA VI S"S-e;.~
TYPE OF WORK 0 New Construction ODeck OPorch ~e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: ~R.C. DI.B.c. o Misc.
Type of onstmction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished mflJrmation 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
above-mentIOned property and that all constructIon will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
otlicia e thIS permIt for . hermore, I hereby agree that the CIty otlicial or a designee may enter upon the propelty to perform needed mspectIons
.JO (tJ L/<.()(
x
Signature
Permit Valuation
Permit Fee
Plan Check Fee
$
$
$
$
$
$
$
$
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
~-/'9""(Jl
Contractor's License No
Date
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
Paid
Date
lfI7! ~
I ~;"iPtNjJlf-r I
ThIS IS to certify that the request m tea ove application and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requcstcd. ThIS document
when signed by the City Planner conStltutcs a temporary Certificate of Zonmg compliance and allows ClJnstruction to commence. Before occupancy, a Ccrtlficate of Occupancy must be
issucd
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