HomeMy WebLinkAboutBuilding Permit 09-0643
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
t.~f.o'
White
Pink
Yellow
File
City
Applicant
\ PERMIT NO. 01. 0(,4-} I
-
\
I =:rs;.- md .... "bottom)
~7~ IYJAeJ6^,C~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
~o
P/J~&12-
(Phone)
Iff7-~/t:t
(Address)
(Phone) b 12-b3~-8~Lt~
(Phone)
BUILDER
(Company Name)
(Contact Name)
(Address)
TYPE OF WORK 0 New Construction ODeck DPorch Re-Roofing ORe-Siding DLower Level Finish 0 Fireplace
OAddition o Alteration DUtility Connection
CODE: DI.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV
H I
2 3
V
M
4
A
R
5
o Misc.
B
S U
PROJECT COST IV ALUE $
(excluding land)
x
I hereby cert". hat I have nlrnished mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
above- tlOne roper 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
officia can revok thO ermit for Jl use Furthermore. I hereby agree that the City official or a designee may enter upon the property to perform needed mspections.
2b~3S59~ ~-2'-t-.o'1
Contractor's License No. Date
Signature
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
Buildinlr Ofticial
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
$ -
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 Cerl1flcate 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