HomeMy WebLinkAboutBuilding Permit 09-0534
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7. z, ().. (/ i
at bottom)
k~-e Qd Sev
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER l)l G-lxj Sr~~.1'
(N ame) (Phone)
(Address) J-~J-S- SL.-v
~~~~~ ~i~IiCanl I PERMIT NO. 09. 0 534+
ZONING (office use)
BUILDER I _a I .
(Company Name) ~,,~ e>fre,l(\.CJrS
(Contact Name) =rrct.V~ Lc.A S ~
(Address) 1 Ltx
c, ( d 5 ( U .. 'J...'#I'-I
TYPE OF WORK. 0 New Construction ODeck OPorch ~e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Conn~n
CODE: DI.R.C. DI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
1
III IV V
HIM
234
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certifY that I have furnished mformation on this application which is to the best of my knowledge true and correct. I also certIfY that I am the owner or authortZed agent for the
above-mentIOned property and 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 this permit for Just c e Futthermore, I hereby agree that the CIty official or a designee may enter upon the propetty to perform needed mspecl1ons.
?-dO -e>;
Date
x
Contractor's License No.
Permit Valuation O()(!1
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"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other
Buildlnu Otlicial
Date
TOTAL DUE
This Application Becomes Your Building Permit When Approved
ThIS IS to certify thaI Ihc request in the above applicatIon and accompanying documenls is in accordance with the City Zoning Ordinance and may proceed as requcsted. ThIS document
when signed by the City Planner consltlutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any