HomeMy WebLinkAboutBldg Permit (Roof/Side) 08-0814
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
IO.(,.6~
File
City
Applicant
I PERMIT NO. ocr: 0114- I
White
Pink
Yellow
at bottom)
1O~IkJ ~1
N~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
(Phone) ~J - t.j.3d~9?(7
(Phone)
1.41 VI
OWNER AI..
(Name) (C. ~
(Address)
J.... \ (} ../ / fc.t ,.,.,
4'3~l( ~'/ I~
LAwtGA(7&
(Phone) q )"(;
BUILDER ~
(Company Name) fS<)nVJcJ2~_
(Contact Name) ~-Q
(Address) f1 31""3 ~r-A-I":J
~~
L.'-1.
---
~r?.. ~(
TYPE OF WORK
DAddition
DLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
m IV V
HIM
234
A
R
5
B
S U
I
E
II
F
I
PROJECT COST IV ALUE $
(excluding land)
I hereby certifY that I have nlrnished mformation on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or authOrized agent for the
above-mentIOned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
:cial caDi::m~~ F=mor~, I :er:agree tha:: official o/a;~: m;;vn;yon the property to perform neede;;;:c;;: 0 B
--..... -.:;,~re Contractor's License No. Date
Permit Valuation
Permit Fee
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
TOTAL DUE
Gas Fireplace Permit Fee
This Application Becomes Your Building Pennit When Approved
Building Ollicial
Date
$
$
$
$
$
$
$
$
$ 1(,.00
ThiS IS to certifY that the request in the above applical10n and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner conslltutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions. if any