HomeMy WebLinkAboutBuilding Permit 09-0500
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
/7262
Lv' " I a.ft'" ^",r~J
Date Rec' d
7. /.5: 1
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. Or 50 () I
Tyl
SF
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
PID
OWNER
(Name)
()~v,'d
f) rvf-DYV
(Address)
(Phone)
e:r)'"'2. '2.. 26 l7 l f
BUILDER
(Company Name)
(Contact Name)
(Address)
14// 101. ~ jJ 13"",' Itl.......J
01:>"" 1<-./ e ~
Lt OJ Ci'Y ~ 15'1
~.s
(Phone)
(Phone)
612 t::tcr.O 61/,;
~S.5 eo
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Conne
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
I
E
ORe-Siding OLower Level Finish 0 Fireplace
o Misc.
B
S U
PROJECT COST /V ALUE $
(excluding land)
I hereby certify that I have fiJrnished 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
abovc-mentlOned 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
official can revoke this permit for Just cause urthermore, I hereby agree that the City official or a designee may enter upon the property to perform necded mspcctlons.
X ~ 20JJ7l6'd 7-/)-~7
Signature Contractor's License No. Date
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 Permit When Approved
Date
Building Ollicinl
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
ThiS IS to certify that thc request in the above application 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 Celtificate of Zomng compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other
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