HomeMy WebLinkAboutBuilding Permit 09-0379
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
(p.r(g, OJ
White File
Pink City
Yellow Applicant
I &= ~.. f1~ ft___
(Address)
BUILDER
(Company Name)
~
(Contact Name) J} j-
(Address)
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TYPE OF WORK 0 New Construction DDeck
DAddition o Alteration
CODE: DI.R.c. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V
HIM
234
A
R
5
(Phone)
(Phone) q~~ -<?Zc5 -, <.;C)~
(Phone)
e-Siding DLower Level Finish 0 Fireplace
o Misc.
B
S U
PROJECT COST /V ALUE $
(excluding land)
I hereby certifY that I have fhmished mformation on this application which is to the best of my knowledge true and correct. I also cel1ifY that I am the owner or authorIzed agent for the
above-menl1on property and that 11 construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can r ke this permit for t cause F1111hermore, I hereby agree that the City official or a designee may enter upon the property to perform needed mspectlons.
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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 Permit When Approved
Buildin!! Ollicial
Date
~O~t'I.
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOT AI... DUE $
ThiS IS to certifY that the request in the above applical10n and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner conSl1tutcs a temporary Cel1ificate 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