HomeMy WebLinkAboutBuilding Permit 09-0287
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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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I White
Pink
3 Yellow
File
City
Applicant
PERMIT NO. 0 q. 0 z...e
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER I<
(Name) .()~
4'J~""-- 6/~ f-)~-1
(Address)
(Phone)
BUILDER /) ). f) . r tJ.. )
(Company Name) ,q-L 4 ~- lu.,STIJrrY""' t' ')roDC1-e '~
(Contact Name) 1> r \ ~ h P,'1. -z....d-e ...-.., .((
(Address) ~3 $- SV/~
(Phone) G> I d- - ~(;).t:J- &;, 7 i'J
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLo~~LEinish
OAddition OAlteration o Utility Connection ~
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
III
H
2
IV V
I M
3 4
A
R
5
I
E
II
F
I
o Fireplace
o Mise.
B
S
PROJECT COST IV ALUE
(exduding land)
$
U
I hereby certity that I have hlrnlshed mtlllmatlOn on this application which IS to the best of my knowledge true and correct. I also certify that I am the owner or iluthonzed agent for the
above-mentIOned property and that all cunstruction WIll conform to all existmg state and local laws and will proceed in accordance with submitted plans I am ilware that the buildmg
:'fiCial ca~e thIS perm or Just cause Furthermore. I hereby agree that the CIty Uffi:;;;~ dzgn3/a7: u5 the pl\lpelty to perform nee~ed I~C;/ ~ ~
Signature Contractor's License No. Date
Permit Valuation 100D.-
Permit Fee $ l4- 1. 7->
Plan Check Fee $ QS.1\
State Surcharge $ -;. !;O
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Date
Building Ofliclal
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 accompanYIng 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 Zonmg complIance and allows constrllctlon to commence Before occllpancy, a Cerlificate 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
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PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 15/2-1 RSff PT'. /&0 .
TYPE OF WORK Oe~ a.,l~ 5:...-" s>~ ~o~
USE OF BUILDING /Uf;f k/~
I
PERMIT NO. 09.0z.&7 DATE ISSUED s. 2-9~o 1
BUILDER tJRCvfr/C..... I PHONE # . ~/l_ z..,u:> G,7C1/
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
I FINAL
5Z/j{j
ETE UNTIL ABOVE HAS BEEN SIG ED
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I (Jh IIP/9/tJ'
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FOR ALL INSPECTIONS (952) 447-9850
INSPECTOR
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PLACE NO CONC
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