HomeMy WebLinkAboutBuilding Permit 09-0641
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
at bottom)
ADDRESS '-f9 3 ( 1s€ ~ e...
White File
Pink City
Yellow Applicant
I PERMITNO.<]_ ~'tl
LJ-:. A1~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
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LOT
BLOCK
ADDITION
PID
OWNER
(Name)
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(Phone)
(Address)
~ (Phone) ~4 ~- 5/ (D-~ l/.:l ')..
(Phone) ~~
TYPE OF WORK 0 New Construction DDeck o Porch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection
CODE: OLR.C. OLB.C. o Misc.
Type of Construction: I II III IV V A B
Occupancy Gro B E F H I M R S U
Division: I 2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
x
hlrnished m rmation on this application which is to the best of my knowledge true and correct. I also cenify that I am the owner or authonzed agcnt for the
and that all onstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
<foe ,"" "" '""hcr=", 1h=b",,", "mbo '" offi",I", :;J;j, '3 '"0" ~oo ~ 5"" ~_m "''if ;:!~ ,.
Contractor's Ltcense No Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
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 $ -; ~.:=.
Paid /' I
Date Bf211tSC
I
I ~~CP6 No.
5A 7 C/ I
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 COnSl1lllles a temporary Cenificate 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