HomeMy WebLinkAboutBuilding Permit 09-0730
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~
at bottom)
ADDRESS
54 :2.q grcok~
C.l' '\
Date Rec' d
~i~i~e ~:~y I PERMIT NO. a - --I "3 0
Yellow Applicant , -1
~~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
-\1
OWNER
(Name)~''''Sc-
(2 ~1t11'\ ,',^ ~ ",
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone) g 52. L."2L, .~ ')2-,
vJe".a~stA-4 ~"~~-rS"
l'y",,^ WoJ ~
529' (,2{Q
., '5"'5" L,l Ci&,
""'(?-)""
~ ~\u
(Phone) I&? $"'(
(Phone) (pS\
vJ ooel b\, C"
TYPE OF WORK D New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition OAlteration OUtility Connection
CODE: ~R.C. DI.B.C.
Type of ConstnIction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V
HIM
234
~
o Misc.
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
G.t ,~ OJ
I hereby certifY that I have fitrnished Information on this application which is to the best of my knowledge tme and correct. I also certifY that I am the owner or authollzed agent for the
above-mentIOned pr 'ry a 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 buildIng
official can revoke t is p rmit r Just us Furthermore, I hereby agree that the CIry official or a designee may enter upon the propelty to perform needed InspectIOns.
C\.ll~{ oC\
Date
x
Signature
Permit Valuation "7 "::)~' u .
Permit Fee $ "1 -~
Plan Check Fee $
State Surcharge $ t- 7-.c::
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This
Becomes Your Building
BUI
'2-OlP ~ \l c:t l "::)-
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 $ L(;r - ,.
I ~;ceiflJF[fr7 c3
Paid
Date
?ff~ ;~
ThiS IS to certifY that the request in the above application and accompanYIng documents is in accordance with the Ciry Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Cenificate 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