HomeMy WebLinkAboutMeter (Lawn Irrig.) #06-0427 oF rR� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� : A:, - �; � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �. Z� ��
�' � �� ��'-; � AND UTILITY CONNECTION PERMIT
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M��'NES��P � Wh��e File pERMIT NO.
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ADDRESS ��� � �-. L ,(� ZONING (ott'ice use)
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LEGAL DESCRIPTION (office use only) ��" �3 �� �?D� Q
LOT � BLOCK � ADDITION PID .
OWNER
(Name) (1'
(Address)
BUII.,DER
(Company Name)�a�ri��_ / �/U,� ..« one) �o v�� /S"6 �'
(Contact Name) Fi��1 {z�t.�s�-- (Phone)
(Address) ! "7 /G «� � ��,
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-S�ding ❑Lower Level Finish ❑ Fireplace
❑Add�hon ❑Alterarion ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. isc. ��� ��'�
T e of Constiuction: I II III N V A B �
� PROJECT COSTlVALUE $
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have h�mished mformahon on this application which is to the best of my knowledge true and correct I also certify that I am the uwner or authonzcd agent for the
above-mentioned property and that all construcuon wip conform to all exisnng stare and local laws and w�l( proceed in accordance with submitted plans. I am aware that the buildmg
official can revoke th permit for �ust cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed mspecaons
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Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; �� $ 50 b . ��
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL D[TE $ SOO, Q
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This Applicarion Becomes Your Building Permii When Approved Paid C�. C�U ReC No. �/ qG
Date S.Z�.�/ Co B
Buildma Utticial Date
Th�s u to certify that the requcst in the above apphcation and accompanymg documents is m accordance w�th the Ciry Zoning Ordinance and may proceed as requ��cted. Th�s dixument
when signed by the Gty Planner consututes a temporary Certi6care of Zomng compliance and allows construcnon to commence. Befure occupancy, a Ceruficate of Occupancy must be
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Planning Director D te Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
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