HomeMy WebLinkAboutBuilding Permit 09-0595
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Date Kec'd
CITY OF PRIOR LAKE BUILDING PERMIl,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
h-rvLA S~;kJ
White File I ERM T a
Pink City P I NO. A f . Stf5
Yellow Applicant , V
ZONING (office use)
rrc-'I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
~
~"tt
(Address)
s~
BUll..DER
(Company Name)
(Contact Name)
(Address) 2/'7 .5 I
(Phone)
51v-C/ch~
(Phone)
(Phone)
~
~/2- '1,u-j(.7Y
#1 K...
TYPE OF WORK 0 New Construction DDeck o Porch ~-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition OAlteration DUtility Connection
CODE: DI.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
III IV V
HIM
234
A
R
5
I
E
II
F
I
o Misc.
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certifY that I have filrnished 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-mentIOn roperty 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
official can re oke his permit for Just caus Furthermore, I hereby agree that the City official or a designee may enter upon the property to perform needed mspectlOns.
X U- -:1~'Sign~ '7.b~~!~r~i[seNo. <6- (0 ~a~7
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
qj/O/d7
Date
~
s
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 $ 76,0-0
I Receipt No. SlfLj 9 'I
By Ie
'J
Paid
Date
CG5~
I} I JOe,
, ,
ThIS IS to certifY that the request in the above applicatlOn 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 Zoning compliance and allows construction to commence. Before occupancy, a Cerl1ficate 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