HomeMy WebLinkAboutBuilding Permit 09-0429
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
ADDRESS
S-Oc tf
(p .2(,.07
White
Pink
Yellow
File
City
Applicant
PERMIT NO. (j
ZONING (office use)
Ie<:
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
Pc ~ l' f <;
(Phone)
7~ )-,.llL/? - {(y);;
fS ( V (.. "1'
(Address)
~ h._
~
BUILDER
(Company Name)
(Contact Name)
(Address)
()c t' I
(Phone)
(Phone)
6 5" l-? ~ -4~6~?
-
Y)1 fV {'~d
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
III IV V
HIM
234
A
R
5
I
E
II
F
I
x
Irnlshe nf ma on on thi. ,pplication which IS to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
nd 1at all nstr Iction WI conform to all eXIsting state and local laws and will proceed in accordance with submItted plans I am aware that the buildmg
It f J t ca se urthe' re, I hereby agree that the my official or a designee may enter upon the property to perform needed inspections
~O ~ 90d I;).. ('-;) 6- ()~
Contractor's License No. Date
I hereby certify that I have
above-mentIOned prope'ry
official can revoke thiS r
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
BlIildll1~ Ollielal
Date
o Misc.
B
S U
PROJECT COST /V ALUE
(excluding land)
$
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 $
ThiS IS to certify that the request in the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certlticate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notiee for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372