HomeMy WebLinkAboutBuilding Permit 09-0279
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
Cl'rc ~~
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Date Rec' d
5'.;;,,1,07
I PERMIT NO. OC;: 00:02- 71 I
White File
Pink City
Yellow Applicant
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"5S] =t- 2...
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
PID
OWNER
(Name) -:S-ed
(Address) ,q 2..\ 0
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(Phone) QS-.J--4o 2-- ll'-fct q
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BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding DLower Level Finish
OAddition o Alteration OUtility Connection
~MiSC.-P~
PROJECT COST /V ALUE $
(excluding land)
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group:
Division:
I
E
A
B
II
F
I
III IV
H I
2 3
V
M
4
A
R
5
o Fireplace
B
S U
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-mentIOned properry 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
otlicial can revoke this pe. .t for Just cause Furthermore, I hereby agree that the CIry official or a designee may enter upon the property to perform needed mspections.
X 0- t-I,
Signature
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
Building Ofticial
Date
Contractor's License No.
Park Support Fee
SAC
#
#
Date
$
$
$
$
$
$
$
$
$
Planning Director
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
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 document
when signed by the li:ity Planner constltutcs a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be
issued
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
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS /tt/.ZIO ~On:; eJ It-
TYPE OF WORK
USE OF BUILDING ~
PERMIT NO.. () DATE ISSUED s: ~
BUILDER PHONE #~Zt '1-1-f9
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I"'" I I
I FINAL I.JG I fJ5 le/zEf/4Y
FOR ALL INSPECTIONS (952) 447-9850
www.cityofpriorlake.com
Phone 952.447.9800 / Fax 952.447.4245