HomeMy WebLinkAboutBuilding Permit #12-655 (Meter Replacement) oF PRlp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /� r��
.. � AND UTILITY CONNECTION PERMIT «
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'yjNNES���' I. White File pERMIT NO. ` .
2. Pink City
; Yellow Applicanl
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ADDRESS — ZONING (ott'ice use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER I _ /�L--_ ���
(Name) � (Phone)
(Address)
BUII.DER �����, / ��� �
(Company Name) ��� �– �����2'//l'� l �� � l.�" (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
DAddition ❑Alteration ❑Udlity Connection �,/� �
CODE: ❑I.R.C. ❑I.B.C. Misc. ' `v � C'J� '""�/�� �
Type of Construction: I II III N V A B PROJECT COST/VALLTE S
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify that 1 have ftimished information un this application which is to the best of my knowlcdge tnie and correct. I also certify that I am the owner or authonud agent for thc
above•menuo erty and that all construction will conform ro all existing state and local ►aws and will proceed in accordance with submitted plans. I am awam that the buildtng
official ca evoke t s perm or a F ermo her a e that the city official or a designee may enrer upon the property ro perform necded mspecti
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'gnatu Contractor's License No. D e
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $ ��. Q
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 DUE $
This Application Becomes Your Building Permit When Approved Paid ""'" Rec � t No.
Date ( ., Z ! B
Buildine Utlicial D�te
This is to certify that the requcst in the above application and accumpanying documents is in accordance with the Ciry Zoning Ordinance and may proceeA as requcsted. This document
when signed by the Ciry Planner constitutes a temporary Ceitificate of Zoning compliance and allows constniction to commence. Befure uccupancy, a Ccitificate ��f Occupancy must be
issucd
Planning Director Date Special Conditions, if any
24 hour noticc for all inspections (952) 447-9850, fax (9S2) 447-4245
4646 Dakota Street Prior Lake, MN 55372