HomeMy WebLinkAboutBuilding Permit 09-0396
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(p.lr.o'1
I White
Pink
3 Yellow
File
City
Applicant
I PERMIT NO. 09. o5'ib I
at bottom)
ADDRESS
ZONING (office use)
,^V\O\. \' ft.::. ~ 5 E ?\~O~ L~ ke. t"\ }J
55?:> 1:1
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
O(Z" OCJ 0
(Address)
(Phone) q5~' 44.1- aS4~
ce \\N S5~1~
}J
(Phone)
BUILDER
(Company Name)
(Contact Name)
(Address)
~~
TYPE OF WORK D New Construction DDeck DPorch
DAddition DAlteration DUtility Con
DLower Level Finish D Fireplace
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST /V ALUE $
(exduding land)
I hereby certifY that I have turnlshed mt(lrmation 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- n ned r.roperty 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
orticial an re ok thi pe It r Just cause Furthermore, I hereby agree that the City official or a deSignee may enter upon the propelty to pertorm needed mspectlons
€>c. ~06 ~ r:l oc:, (;- l ~ - O~
Signature
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 $
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
Date
This Application Becomes Your Building Permit When Approved
Buildlll!! Orflelal
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 Cay Planner constItutes a temporary Certificate of Zonmg compliance and allows constructIOn to commence. Before occupancy, a CertIticate of Occupancy must be
issued
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