HomeMy WebLinkAboutBuilding Permit 09-0493
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
White
Pink
Yellow
File
City
Applicant
PERMIT NO. 09.
3 Ow 2-
L/l% f-ffI VeN
c;;I
Date Rec' d
7. Cl07
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
PID25.~1 J Of Q. '0
(Address)
(Phone)
(Address)
/-,c... . ,4-'t
BUILDER
(Company Name)
(Contact Name)
-,
eo
NA . , tJc...._
,
(Phone)
(Phone)
'~4 ,.4-,A--
(P IZ. 702. ~ 2357
~~]~.
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration OUtility Conn tlOn
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 U
PROJECT COST IV ALUE
(excluding land)
$
1 hereby certify that 1 have furnished mformatlOn on this application which IS to the best of my knowledge true and COlTec!. I also cerllfy that I am the owner or authorIzed agent fllr the
above-mentIOned property and that all construction will conform to all eXlsllng state and local laws and will proceed In accordance with submitted plans. 1 am aware that the buildmg
official can revoke thiS perml! for Just caus' . ermore, I hereby agree that the crty official or a deSignee may enter upon the property to perform needed InspeCllons.
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 $
This Application Becomes Your Building Permit When Approved
l3uildllll! Ofliclal
Date
2D/7 ?~~ 5
Contractor's License No.
Park Support Fee
SAC
#
#
7" 9.0 r
Date
$
$
$
$
$
$
$
$
$
-
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
t No. 58.3.38
ThiS IS to certify that the request in the above applicatlon and accompanymg documents IS m accordance wllh the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constItutes a temporary Certificate of Zonmg Cllmpliance and allows construction to commence Before occupancy, a Certificate of Occupancy must be
issued
Water Tower Fee
Builder's Deposit
Other
TOT AL DUE
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