HomeMy WebLinkAboutBuilding Permit 09-0409
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White File
Pink City
Yellow Applicant
PERMIT NO. 09.0
at bottom)
Date Rec' d
(P. ~2--1
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) 5 J/~~ ;r &Jt..-AIfL
(Address) /:
,.
.co v//:75k~elllL
V
,y,
PID
(Phone) 9..>.2- ~P.2- ?6'1?"Z
~
BUILDER
(Company Name) U/~c5/V7';; t:::'e~r
(Contact Name) ./14/ A;-2:,
CS"~".P~ /At:: (Phone) 7~?-S-~ -t::'J&1~
(Phone) II I r " /
(Address)
V'" .&-
~
TYPE OF WORK 0 New Construction o Deck OPorch ~Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: OI.R.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
$ /1-2?~~
I
E
II
F
I
III IV V
HIM
234
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
I hereby certify that I have f\Irnished mformation on this application which is to the best of my knowledge tme and correct. I also certIfy that I am the owner or authorIzed agent for the
above-menuoned 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 buildmg
official can revoke this permit for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspectlOns.
X ~ Y Af1~ 02t!:J/SSSt5t5 t76-~tf2-I!t)F
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Park Support Fee
SAC
$
$
$
$
$
$
$
$
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
TOTAL DUE
~~~ ?/i"--:D J
7
I ~;1J;NO. ~2('[
omes Your Building Pennit When Approved
#
#
#
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$
$
$
$
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$
$
$
ThIS IS to certify that the request in the above applicatIon and accompanymg 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 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