HomeMy WebLinkAboutRe-roof/Re-Side Permit
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2 Pink City
3 Ye\low Applicant
;.53h{)
S~5D5R-
CUlL
NING (office use)
i
,;", PU':;O
LEGAL DESCRIPTION (office use only)
LOT / BLOCK / ADDITION !Ill I tV OSOAf
2Alo
PID 2,5---312 - Of) 1-0
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
De,
J&6/VJ~ot5 L,.,I tJCj
447- 76/37
(Phone)
(Phone)
TYPE OF WORK
o New Construction
DDeck
Re-Roofing
o Lower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
DAddition
DAlteration
o Mise,
DPorch
Re-Siding
o Utility Connection
I hereby certifY that I have furnished information 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-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 building 0 'I can re ke this permit for just cause, Furthermore, I hereby agree that the city official or a designee may
enter n e pet form needed ins ns,
x .
Permit Valuation 2-/~OO.()O
Permit Fee $ 7L/ -y?:'
Plan Check Fee $
State Surcharge $ /. '2-)
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
itY //JJ:. ) -
~
Building Official
/ z - '&U' () I
Date
Contractor's License No,
)"2/'2 t;/O /
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ ,/&.aO
Paid
Date
~& . () 0
'7.~Z&-'O ,1
I ~e;f14}!Z 7-
This is to certify that the request in the 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 constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date 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