HomeMy WebLinkAboutBuilding Permit 09-0680
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I ~~~~md'A~bloA)D?D
Date Rec' d
t; , 3_6,/
White
Pink
Yellow
I PERMIT NO.09, 0 ~ f) () I
I
File
City
Applicant
ZONING (office use)
Dr<
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
DfrlJ I!) ~ C 1\ r/ ~tr Y\e..
(Address)
fk~v
q5d-~7' hD~
(Phone)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK o New Construction ODeck o Porch ORe-Roofing ORe-Siding OLower Level Finish o Fireplace
OAddition OAlteration DU"h", C'""~,,," f 12 (~ 13' 5~eP
CODE: DI.R.C. DI.B.c. MIsc.
Type of Constmction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
x
I hereby certiIY Ihat I have fi.1rnished mformation on this application which is to Ihe best of my knowledge true and correct. I also certiIY that I am the owner or authorIzed 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 submitted plans. I am aware that the buildmg
offici can r oke this permit for Just c nh 'mo I hereby agree that the City official or a designee may enter upon the propelty to perform needed mspections.
q - ~- oq
Date
Permit Valuation 2,.560, U 0
Permit Fee $ ?c.I. 1!:'
Plan Check Fee $ --,
State Surcharge $ .--r
/. Z~
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
mes Your Building Pennit When Approved
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 $ 1&.00
,
~1o
ThiS IS to ce" IY that the request in the above applicallon and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requcsted. This document
when signed y the City Planner consl1lutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Ccrl1ficatc of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any
PRIOR LAKE DEPARTMENT OF
. BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 5499 /l/VltflbWo 00 P/L-
TYPE OF WORK ~ /2- '" (] I
USE OF BUILDING IzeI /1/ It-
PERMIT NO. .09 _ () (p 1(;0 DATE ISSUED tl. ;3" oq
BUILDER 1:/ER:-e!L PHONE # fiSt. 801. ~abfD
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR '
,.....!Il 'I J I
, ,I
PLACE NO'CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I..... ' <rf',- le~ (~(./,y I
J
DATE
I
I
I
~l
, FI NAL
FOR ALL INSPECTIONS (952) 447-9850