HomeMy WebLinkAboutBuilding Permit 09-0487
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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Date Rec' d
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1 White
Pink
Yellow
I PERMIT NO. 0 Cf. 0 4fJ 71
I
ZONING (office use)
File
City
Applicant
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
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(Phone)
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(Address)
BUILDER ' ------
(Company Name) t~ l'fc,{'I'^J\\.J((
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(Phone) CIS Zp. t! '7 '( s '7 .$
(Phone) SA""" '-
(Contact Name)
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TYPE OF WORK 0 New Construction ODeck OPorch ~Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration OUtility ConnectIOn
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
o Misc.
B
S
PROJECT COST/VALUE
(excluding land)
$
U
I hereby certify that I have hlrmshed m!()rmation on this application which is to the best of my knowledge true and correct. I also certify that I am the lJwner or authorized agent for the
ab?ve.mentlOne....~d.lf.C operty and that all clJnstruction Will conform to all eXlstmg state and local laws and will proceed in accordance with submIlled plans I am awa. re that the buildmg
offIcial can revo"~Js perml! for Just cause Furthermore, I hereby agree that the City offiCial or a deSignee may enter upon the property to perform needed mspectHJns
X /~//")/'~ ~l ~.z -0 1
// Signature Contractor's License No. Date
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 $
This Application Becomes Your Building Permit When Approved
8uildlll~ OffiCial
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
$
ThiS IS to certify that the request in the above application and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
isslIed
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