HomeMy WebLinkAboutBuilding Permit 09-0559
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CITY OF PRIOR LAKE BUILDING fERMIT.
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
00101,'~
!2c>cJ
D~t~ K~(!' d
White
Pink
Yellow
I PERMIT NO. 0 C; , 5.5 i I
File
City
Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
G~(f
+
L I ''/\M c..
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
a, M. W Ha.,,f y WrO'......
A V) VI 1-/0, 1~
29o~ f!l'nt./IOr_
(Phone)
Sf~C-
(Phone) to/~ - 8b7.. gAg 7
(Phone) c6/z - <667-8J.... & 7
r2-1~ -
C'htJ?
TYPE OF WORK 0 New Construction DDeck OPorch '8f[e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: DI.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V
HIM
234
A
R
5
o Misc.
B
S U
PROJECT COST /V ALUE $
(excluding land)
C;~oO
lmished mforma on on this application which is to the best of my knowledge tme and correct. I also certify that I am the owner or authof!zed agent for the
above-mentIOned prop and tha~ . .uction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
s permit for Jlist C)1l Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspecl1ons.
/ ZOt./'I3?../3 7-27"'Ca,
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
?/2~1
Date
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 $ 7~ .- C!7C/
Paid
Date
V=f: .
"2 ?/Oe,
Receipt No. S~ L/ S 2.
By J7:.
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 docu ment
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Cerl1fieate 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