HomeMy WebLinkAboutBuilding Permit 09-0839
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/0. /4-. O(
at bottom)
ADDRESS
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. Oq 0 037 I
ZONING (office use)
L f'VlAi
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER A A - /
(Name) IV I/I<..E.{ Dtf3
(Address) 0
BUILDER '.
(Company Name~~ VI.$~ ~ -;'7fifl.J ~ <,
(Contact Name) ~ ~ IL
(Address);;L L
(Phone) ~ I L-- -, 5 ~-"I3'-fS"
s
(Phone) (PI 2.. '4Q () - J z. 7.-~
(Phone) (&)1 'Z.. - 5 7~- 4 70-z..
MfJ 5530
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish
OAddition OAlteration OUtility Connection
o Misc. f!EPt../feC
CODE: OI.R.C. OI.B.C.
Type of Constnlction:
Occupancy Group:
Division:
I
E
II
F
1
III IV
H I
2 3
V
M
4
A
R
5
B
S U
~ 5K-'f';rldr5>
PROJECT COST IV ALUE $ () aoc.>
(excluding land)
I hereby certify that I have htrnished mformation on this application which is to the best of my knowledge true and COlTec!. I also certify that I am the owner or authonzed agent for the
above-mentlOne a II construction will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
otftcial can revo cause Furthermore, I hereby agree that the Ctty official or a designee may enter upon the property to perform needed mspectlOns
A
B
x
ature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
BuildltH! Ofticial
Date
o Fireplace
(}.O(t) ~(j3 9.3
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 $
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 Certlticate 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