HomeMy WebLinkAboutBuilding Permit 07-1094
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
II. /3. () 7
(Please type or print and sie:n at bottom)
ADDRESS
] White
Pink
Yellow
I PERMIT NO. 07. 1094- I
File
City
Applicant
ZONING (office use)
/450+-
-
~ U3Jt/ Dfr'~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER ~ d 1.
(Name) ./f YI e Y
"I- .f/11 LoWjvy BoAl;;
Ok e
(Phone) 9 ~2- .22~- :Jc~Z
, .
---2-
(Address)
BUILDER
(Company Nameh.A/f S?l-/ )')/ Ihc/i~~ l '7 .5/ P/ A/E
(Contact Name) #I ): E
(Address) / ~t}
(Phone) /~3- 5':?/-C~CJ'
(Phone)
D597'1
TYPE OF WORK 0 New Construction ODeck OPorch ~Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration o Utility Connection
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
III
H
2
IV V
I M
3 4
A
R
5
I
E
II
F
I
o Mise.
B
S
$
PROJECT COST/VALUE
(excluding land)
U
I hereby (('nity that I have turmshed informatIOn on this application which is to the best of my knowledge true and correct. I also cL'rtlty that I am the owner or authorIzed agent for the
JbOVC-mentlllned property and that all constructllln will confiJrm to all eXlstmg state and local laws and will proceed in accordance with submltled plans I am aware that the buildmg
oflieral can revoke tlm permIt for Just cause Furthermore. I hereby agree that the CIty official or a deSignee may enter upon Ihe property to perform needed mspectu1l1s
X 0- . ,,-/: (#~..2 1~/S5fft/~ I///Y/ ?
Signature Contractor's License No. ' 'Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
! Plumbing Permit Fee $
Mechanical Permit Fee I $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Permit When Approved
lluildltll! Urticlal
Dale
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
ThIS IS to certIfy that the request 111 the above application and accompanYll1g documents is in accordance with the City Zoning Ordinance and may proceed ,IS requested ThiS document
when signed by the City Planner CllnstItUtes a temporary CertIficate of Zonll1g complrance and allows cunstructlon III commence Before occupancy. a CertIficate of Occupancy must be
isslled
Planning Director
Special Conditions, if any
Dale
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372