HomeMy WebLinkAboutBuilding Permit 07-0136
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Address)
"'OJ1/! {JJ. r I
sI-ad
Date Rec' d
3. Z Ci. 01
I White
Pink
Yellow
File
City
Applicant
PERMIT NO. (J?, 0/30
ZONING (office use)
PID 2-5.
)QM.lf --r iL
(Phone)
9)ltj9 V_'Oo}1
BUILDER
(Company Name)
(Contact Name)
(Address)
('r; r1 ') f....
(Phone)
(Phone)
0(2- 8' 7 'Y:,(7)
,
TYPE OF WORK 0 New Construction ODeck OPorch -Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
OAddItlOn OAlteration o Utility Con ectlOn
CODE: OLR.C. OLB.C. o Mise.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certity that I have hlrmshed informatIOn on this applicatton which IS to the best of my knowledge true and correct. I also certlly that I am the owner or authorIzed agent tor the
abnvC-mCI1tlOncd pro) ,. , d that all construction will conform to all eXlstll1g state and local laws and will proceed in ilccordilf1ce with submltted plans I am aware that the btllldmg
official can fevo ' IS pel st cause Furthermore, I hereby agree that the City official Of a designee may enter upon the property to pert(1fm needed mspectltms
~ 2Q)3.jo 0 , ----3.-.2/))-- 01_
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechal1lcal Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
This Application Becomes Your Building Permit When Approved
Butldlng umClal
[)at~
Contractor's License No.
D,lte
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water ConnectIOn Fee # $
,
Water Tower Fee # $
Builder's Deposit I $
Other $
TOTAL DUE $ '7&. 00
ThiS IS to eertlty that the request in the above applicat1l1n Jnd accompanYll1g documents is 111 accordance with the City Zoning Ordinance and may prllceed as requested ThlS document
will'll signed by the City Planner constitutes a tcmporalY Certificate of Zonmg cllmphance and allows constructIOn to Cllmmence Befme occupancy, a Certlticate of Occupancy must be
i.<;sLled
Planning Director
Special Conditions. if any
Date
24 hour notice for all inspections (952) 447-98511, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372