HomeMy WebLinkAboutBuilding Permit 09-0734
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
9. 17. () /
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I PERMIT NO. 0 9. 07341
I
White
Pink
Yellow
File
City
Applicant
-r~,'J
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
9S;;z- - ~ ~ / - S";;L g-c
vtJH y/ CYamy
.57aJref'
.
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
O~/~Z41 U,M~",CTi'h
0&'1 n DA/c 7q/
I"d.
---
(Phone)
(Phone)
9-S-;;?-- ? ~ 7- b~~
T-J'7C,
TYPE OF WORK. 0 New Construction ODeck OPorch ORe-Roofing MRe-Siding OLower Level Finish 0 Fireplace
OAddition o Alteration OUtility Connection
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
1
III
H
2
IV V
I M
3 4
A
R
5
B
S U
PROJECT COST /V 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 authorIZed agent for the
above-mentIOned properry 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 oke this permit ~ cause Fur ermore, I hereby agree that the Clry official or a designee may enter upon the properry to perform needed mspections.
x
#
#
Permit Valuation
Permit Fee
Park Support Fee
SAC
$
$
$
$
$
$
$
$
TOTAL DUE
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
This Application Becomes Your Building Pennit When Approved
Building Ollicial
Date
Date
$
$
$
$
$
$
$
$
$
ThiS IS to certifY that the request in the above application and accompanying 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 Celtificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
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
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