HomeMy WebLinkAboutBuilding Permit 09-0530
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CITY OF PRIOR LAKE BUILDING PERMIT \
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Dutc ReG' d
7- r7~ () f
File
City
Applicant
I PERMIT NO. oq~ 0 S3 0 I
White
Pink
Yellow
ADDRESS , II
11$-"0 WI cteY-hess JrlN'l
~-, 0 (- Ll1--l e. )//fj SYJ ')
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
OWNER
(Name)
/-1/11
; 1lu-~-eJ) s
(Phone) 6/d. -))6.-' If /10
(Address)
t y-/c
,7-lfo
6<;- /-4&7-0000
(Phone)
(Phone)
.;- OJ
TYPE OF WORK 0 New Construction ODeck
OAddioon OAlteration
ORe-Siding DLower Level Finish 0 Fireplace
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
o Mise.
IV
I
3
V
M
4
A
R
5
B
S U
I
E
II
F
1
III
H
2
PROJECT COST IV ALUE
(excluding land)
$
I hereby certifY that 1 have hlrmshed m!()rmation on this application which IS to the best of my knowledge true and correct. I also certIfy that 1 am the owner or authol'\zed agent for the
aboVl'-mentlOned property and that all construcl1on will conform to all eXlstmg state and local laws and will proceed m accordance with submItted plans I am aware that the buildmg
:ticial~ mlt for J ,;==e. I. hereby agree that the CIty OffiJ '0 6Si3~mr Oe~pon the property to pertorm nee1?77'7o 1
Signature Contractor's License No. ' Date
Park Support Fee
#
#
Permit Valuation
Permit Fee
$
$
$
$
$
$
I $
$
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permtt Fee
$
$
$
$
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Date
l3uilct1ll!! Otlicial
z.
Th,s IS ([) certifY that the request m the above applical10n and accompanymg documents IS m accordance with the City Zoning Ordinance and may proceed as requested TIllS document
when signed by the City Planner conSl1tutes a temporary Certificate of Zomng compliance and allows construction to commence. Before occupancy, a Certlticate of Occupancy must be
issued
Special Conditions, if any
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372