HomeMy WebLinkAboutZoning (Platform) Permit 09-0021
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
~.Z2-_01
II Z ~ Z, Ic!>r
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White File I PERMIT NO
Pink City . 0 &1. 002-1
Yellow Applicant , ' .
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ZONING (office use)
PlH
.55'"37
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
OWNER
(Name)
l)UlN-1
R re..u...t.....('"
(Phone)
'15'2- L/47-~fR.5 7
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK o New Construction DDeck o Porch ORe-Roofing
OAddition o Alteration OUl1lity ConnectIOn )(MISC
CODE: OI.R.C. OI.B.C.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
ORe-Siding OLower Level Finish 0 Fireplace
L-Owe/L.. Pe2K-
PROJECT COST IV ALUE S
(excluding land)
x
I hereby certify that I have htrnished Information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authoftzed agent for the
above-mentIOned property and that all construction will conform to all exisl1ng state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can ' this permit for JUSI cause FlIIthermore, I hereby agree that the City official or a designee may enter upon the property to perform needed Inspections.
~ / ZZ/Oq
. date
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 $
ecomes Your Building Permit When Approved
Date
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter SizeS/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $
Paid
Date
ThiS IS to cenify that the request in Ihe 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 constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certtficate 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