HomeMy WebLinkAboutBuilding Permit 09-0577
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
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White
Pink
Yellow
File
City
Applicant
I PERMIT NO'(_ Sf 1
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
OWNER
(Name)
S ~\J" ~ ~~ '"
\~'h~" ~~-tQ~
~.
(Address)
(Phone) ~-~'\~-G<\Q3
~'(\o~ \4~
(Phone) G)\~- <O3~ -S~Ql\
TYPE OF WORK 0 New Construction ~eck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition o Alteration OUtility Connection (i:) _ \ \ \....
D D OMiSC.~~\,,~ ~~V~ t~\\'c\~
CODE: I.R.C. I.B.C. ""-
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $ ,5 QO, ~ 0
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5 (excluding land)
I hereby certifY that I have lhmished mformation on this application which is to the best of my knowledge true and correct. I also celtifY that I am the owner or authof1zed 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, I am aware that the buildmg
o CI an re, his rmit fo ust cau e, Fll1thermore, I hereby agree that the City official or a designee may enter upon the property to perform needed mspectlOns.
~\\S -t\\)~ 3\ cl~Q,\
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
$
$
$
$
$
$
$
$
"IS&>? --
Z5,'
({, . ")..-)
. S"o
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Your Building Permit
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 $ 4-1 . -, 5""
~~
I ~;ceiPt~
Paid
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 constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372