HomeMy WebLinkAboutPlumbing Permit 09-0636
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND U ION PERMIT
'"
File
City
Applicant
Date Rec' d
6- 20_0J
I PERMIT NO'09. O&3f.o I
PLfi/3fj_
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
ZONING (office use)
OWNER "
(Name) ., ~ ~
(Phone)
? .s - 2- - 2 :2 ~ _ c/2 ell
'f7= -~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Const~n ODeck o Porch ORe-Roofing
OAddition ~lteration OUtility Connection
CODE: DI.R.c. DI.B.c. 0 Misc.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding OLower Level Finish
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
I hereby ccrtify 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 authonzed 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 submittcd plans. I am aware that the building
offiCIal can revoke thIS permIt for Just cause~ ~~' I heleby agree that the clly offiCial or a desIgnee may enter upon the property to perform needcd mspectlons
X ~/~ 8 -:u>-~()
Signature Contractor's License No Date
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $ ~O_OO
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Building Oflicial
Date
$
$
$
$
$
$
$
$
$ 50- 0 0
ThIS IS to certify that thc rcqucst in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requcsted. This document
when signcd by the City Planner constltutcs a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issucd
Special Conditions, if any
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372