HomeMy WebLinkAboutBuilding Permit 09-0775
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
1~8/ 1'1&11t/tJtV
/h/c,
Date Rec' d
92-~ CI ~
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 0 9" 0 71 51
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
1
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(Address)
PID
(Phone)
((PI 2-) -:2- 2-C:'5/~b
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BUILDER
(Company Name)
(Contact Name)
(Address)
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(Phone)
(Phone)
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TYPE OF WORK 0 New Construction ODeck DPorch Re-Roofing DRe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connec ion
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
DMisc.
B
S U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certiI)' that I have furnished information on this application which is to the best of my knowledge true and correct. I also certiI)' that I am the owner or authOrIzed agent for the
above-menl1oned 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
ollicial 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 necded Inspecl1ons.
'}ob~)?71 f(!z.~/",
Contractor's License No. Date
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 $
x
~
- I.-;;I-:--~
Signature
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 Permit When Approved
Building Otlicial
Date
ThiS IS to certify that the request in the above applical10n and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner conSlitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate 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