HomeMy WebLinkAboutBuilding Permit 09-0213
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s--,e:,.oo CITY OF PRIOR LAKE BUILDING PERMIT, &5..~LI3
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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Date Rec' d
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I White
Pink
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I PERMIT NO.Or. 0 Z GI
File
City
Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNE~
(Name) ~\( I,J
rtZ€~G11t
(Address)
(Phone) C"l5a -y,yO ls<1g
BUILDER I \ _
(Company Name) We-A-n\i1?....-00PrR.O
J(A ef;,f\
m6t-.1\OP-I~L Avt
C{)r\Sl~, 'JOl0n
(Contact Name)
(Address) .5W4-
tJ. .
TYPE OF WORK 0 New Construction ODeck OPorch
OAdditlon OAlteration o Utility Con
(Phone) 1d51-431-t.\~
(Phone)
55D r
m(\
Re-Siding OLower Level FinIsh 0 Fireplace
13t6 ~
CODE: OLR.C. OLB.C. o MIsc.
Type of Constmction: I II III IV V A B PROJECT COST IV ALUE $ \0 I (--eLI, 00
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby (('nity that I have furmshed mformation nn this application which IS to the best of my knowledge true and correct. I also certIfy that I am the owner or authOrized agent tor the
abllvc-mentlllned property and that all Cllnstructllln Will contlJrm tll all eXIstmg state and lllcallaws and WIll proceed m accordance with submitted plans I am aware that the bluldmg
(ltlicial can revoke thlS permit for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the propel1y to perform needed inspections
X -fA. ~ ~D~~~y~4 b/f:/D9
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $ i
This Application Becomes Your Building Permit When Approved
llutldlllg Ufficlal
Datc
Park Support Fee # $
SAC # $
Water Meter Size ;i/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit
ThiS IS to certify th;tt the request in the above applIcation and accompanYlllg documents is 111 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner clmstltutes a temporary Certificate of Zoning compliance and allm.vs construction to commence Before occupancy, a CertIficate of Occupancy must be
I.sslled
Planning Director
Speeial Conditions. if any
Dale
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372