HomeMy WebLinkAboutBuilding Permit 09-0656
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
8,2701
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 69. () (;!::(, I
at bottom)
ZONING (office use)
51 -r() JJr~o}(s
,
f!., ~ ": -$~;
py/,,.. L<<k~
~') S-537~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) H~ - )/
(Address)
p
Wc>~L ..,
(Phone) 9'2-~f7.s-~JI~
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck DPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition DAlteration OUtiJity Conn ctio
CODE: DI.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
I
III IV V
HIM
234
A
R
5
B
S U
PROJECT COST/VALUE $
(excluding land)
I hereby certifY that I have furnished 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 propelty and that all construction will conform to all exisl1ng 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 FlIlthermore, he~eby agree that the CIty official or a designee may enter upon the properry to perform needed mspectlOns.
x
Contractor's License No.
8-~-PJ'
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 $
Park Support Fee
SAC
Paid
Date
7f -
& ~1'C)J
# $
# $
$
$
# $
# $
$
$
$ 7~. 00
~~o SB7S1
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Pennit When Approved
Building Otlicial
Date
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 City Planner consl1lutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate 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