HomeMy WebLinkAboutBuilding Permit 09-0629
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
i1 g 1 tl
ErlA c-/~
s;. ~ ,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNE~
(N ame) . rof"'\
Ar~f
Date Rec' d
8, r7. Or
~i~~e ~:;y I PERMIT NO. 00. oro2.. C/i
Yellow Applicant , 7. P
PID
ZONING (office use)
(Phone) G/~ -^o7- c,JJ./
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
I hereby certify that I have f\irnished mformation on this application which is to the best of my knowledge tme and correct. I also certify that I am the owner or authoflzed agent for the
above-mentIOned property and that all constr. 1 conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can revok' permit for Just e Fu thermor I hereby agree that the my official or a designee may enter upon the property to perform needed mspections.
TYPE OF WORK 0 New Construction DDeck o Porch
OAddition OAlteration OUtility Con
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V
HIM
234
x
Signature
Permit Valuation Z~5VO. 00
Permit Fee $ 7~. 7r
Plan Check Fee $ .,
State Surcharge $ /.2-~
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Building Otlicial
Date
A
R
5
e-Roofing
ti n
ORe-Siding
OLower Level Finish
o Fireplace
<is
, } J - c) 4_
Date
o Misc.
B
S U
PROJECT COST/VALUE $
(excluding land)
$
$
$
$
$
$
$
$
$
ThIS IS to certify thatlhe requcst in the above applicatIOn and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requcstcd. ThiS document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Ccrtificatc of Occupancy must be
issued
Contractor's License No.
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
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