HomeMy WebLinkAboutBuilding Permit 09-0513
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~~ @ ~~eWe~~
W JUL 15 2009 W
White File
Pink City
Yellow Applicant
By
PERMIT NO.
-5\3
at bottom)
14 17 a I?I'\~ befl.... (" J'V I PILI ()~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNE~
(Name) E ~ II\)
@) Fl-E"""9YV"
(Address)
PID
(Phone)
? S1..- 'I9{, - ?1..1'
BUILDER
(Company Name)
(Contact Name)
(Address)
~J4trv? t
^'" N
(Phone)
(Phone)
'I
/
/
TYPE OF WORK o New Construction eck o Porch ORe-Roofing ORe-Siding OLower Level Finish o Fireplace
OAddition DAlteration OUtility Connection
CODE, ~'R'C' OLD.C. o Misc.
Type of onstnIction: I II III IV V A B PROJECT COST /V ALUE $ /O,OeJc:J
Occupan Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certifY that I have filmished mformation on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or authonzed agent for the
above-mentlOne roperty and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official ca oke his permit ust cause Fm thermore, I hereby agree that the City offiCIal or a deSIgnee may enter upon the property to perform needed mspecl10ns
X ?;; r-/ttJ 9
SIgnature Contractor's Ltcense No. ~
Permit Valuation
Permit Fee
$
$
$
$
$
$
$
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
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
Paid
Date
71~
I ~~ceiPt ~4t3
#
#
#
#
$
$
$
$
$
$
$
$
$
pplical10n and accompanymg documen is in acc dance with the City Zoning Ordinance and may proceed as requested. ThIS document
nce and ows construction to commence. Before occupancy, a CertIficate of Occupancy must be
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS ~ l~ ~A[;b'ft C,,L
TYPE OF WORK 1)
USE OF BUILDING :s
PERMIT NO. e7t,. 5( S DATE ISSUED r S-
BUILDER ~~~ PHONE #~Z.~"...~z.~"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
FOOTING "V t-buSd' ~ , 'J
PLACE NO CONCRETE UNTIL ABOVE H S BEEN SIGNED
~ I I I
I FINAL I ~ 1~ I
FOR ALe INSPECTIONS (952) 447-9850
DATE