HomeMy WebLinkAboutBuilding Permit 09-0449
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
While
Pink
Yellow
File
City
Applicant
PERMIT NO. () r. 0
5/#4-
~otf~ ~
Date Rec' d
7~ {,(/ 9
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
f::- ~:T' c...1\.,.,' 0'4..$
12 'Z. ~., "-l ~c....o I ~I A..., <L.
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition DAlteration DUtility Conne
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
S"o~
12.- 2..~o- J.f/~t)
ORe-Siding OLower Level Finish 0 Fireplace
o Misc.
B
S U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I have hllnIshed mformatIon on this application which IS to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
above-mentioned property and that all cnnstructllln will conform to all existmg state and local laws and will proceed in accordance with submItted plans. I am aware that the buildmg
official can revoke this permIt for Just cause Furthermore, I hereby agree that the City official or a destgnee may enter upon the property to perform needed mspectlllns
x
~
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 Pennit When Approved
Buildint! Ufficial
Date
2o(,~J j r 4 o~
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
I Paid ~&, --
Date ./10/
#
#
#
#
~PtNO
$
$
$
$
$
$
$
$
$
~L1J
,
ThiS IS to certify that the request m the above applicatIon and accompanymg documents IS in accordance with the City Zoning Ordinance and may proceed as requesled ThIS document
when signed by the Cily Planner constItutes a temporary Certificate of Zoning compliance and allows constructIOn to commence. Before occupancy, a Certlticate 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