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HomeMy WebLinkAboutWater Meter Upgrade a. (CPR.i• CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE - x 0 AND UTILITY CONNECTION PERMIT M INNESOo' l'' 0 7- cuoe`1 t . white File 2. Pink Cit P ERMIT NO. + I 0053 3 Yellow Applicant (Please type or print and sign at bottom) ZONING (office use) ADDRESS C 1 0 1 FA ‘ (____ . "\ a T- . LAJ. LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION ' PID OWNER J r (Phone) 6" 1 .Z " 3�'q -1112- (Name) i L L 4 -E i � p� (Address) 1,1-i.;,' ` iz..> Al LA% i G v. /'rt t,' .� -•�-�A.� —� 1 l ■1 BUILDER (Phone) (Company Name) (Contact Name) (Phone) (Address) TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re- Roofing [Me- Siding ❑Lower Level Finish Cl Fireplace DAddition EAlteration ❑Utility Connection oiA,-✓-<---P CODE: ❑I.R.C. I.B.C. ❑ Type of Construction: I II III IV V A B PROJECT COST /VALUE $ Occupancy Group: A B E F HI MR S U (excluding land) Division: 1 2 3 4 5 I I hereby certify that I have furnished inform ion 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- mentro d property and that all con ruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official ca revs k this permit for ∎ use Fur ,. ermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. /> ( --. C 2 ' 40'-' 11 1 X - Fill . . -� l ir Date re Contractor L icense No. Permit Valuation Park Support Fee # $ Permit Fee $ SAC # $ Plan Check Fee $ Water Meter Siz &; 1 "; $ 1, 1 t2 State Surcharge $ Pressure Reducer $ 1°' 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 DUE $ 7 Q© !' This Application Becomes Your Building Permit When Approved Paid 700 . (4_,) I Re B ipt No. 6 LU L 4--- I y Date 4 7,e, , / Building Official Date This is to certify that the when signed by the City Plannerrct n the constitutes es a temporary Certificate accompanying Zonn g and c allows construction to comm nce. Ordinance fore occupancy, Certificate requested. ofOcct Occupancy be issued. Planning Director Date Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street Prior Lake, MN 55372