HomeMy WebLinkAboutBuilding Permit 09-0706
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
ADDRESS
\ 41155
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. Cf -ltJ0
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
~
OWNER A _
(Name) ~RA
(Phone) 3.. ~ - J..{. '-/CJ - [5 q ~5
(Address)
SA
~
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck DPorch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition o Alteration DUtility Connection
CODE: DI.R.c. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V
HIM
234
o Misc.
A
R
5
B
S U
PROJECT COST /V ALUE
(excluding land)
$
[ hereby certifY that [ have fl1mished mformation on this application which is to the best of my knowledge true and correct. I also certifY that [ am the owner or authoflzed 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. [ aw re that the buildmg
~ :~' ,~," d,,, _d '''' '" F"rth"~re.' boreb, 'w" d,,' ,'" '" ,m,o' rn' do'''''' m" ~'" "I'''' ,'" I'm"", m ""f,,,, ",,",d 10" "'0
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Contractor's License No.
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ l~"''''
I Reoeipt NO-ffl- <[1
By 11
\ Paid
Date
?(~ ("'1
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 conSl1lUtes a temporary Certificate of Zonmg 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