HomeMy WebLinkAboutBuilding Permit 07-0334
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE. .
AND UTILITY CONNECTION PERMIT
I~~~;:;~o
Date Rec'd
I. While Fil.
2. Pink City
] Yellow Applic:a..
I PERMIT NO. 07. 0334-1
I I WNmG,__, I
Ave, SS.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
l&~ccfr+ Pcu 110.-
(Address)
AM<<f~rl
(Phone)
Q'~1-S
:: Name) :l t1 '/)11 e;J" ar'/ &hCf h:I<-{/J {j/1
(Contact Name) tV't.
(Address)5&l// /, em~r/a..1 /fr. /Y. 7~ 'Wa-A:r
TYPE OF WORK O\New Construction ODed OPorch
OAddition OAlteration OUtility Connection
. CODE: OI.R.C. OI.B.C.
Type of CoDStruction:
Occupancy Group:
Division:
n mIVVAB
F HI MRSU
I 2 3 4 5
I
A B E
(phone) uG-;'~?J9. ~3XJ
.
(phone)
5-S()E'aL
OLower Level Finish 0 Fireplace
PRomcrcoST/VALUE S ~,J.'38 .?J!)
(excluding land)
I betrlly certify that I have furnished information on this appllcatlon which is 10 the best of my knowleclge lrIIe and cornet. I also certify that I am the Uwn<T or authonze.'<i aFnl for the
above-mentIoned propmy and that aU construction will conform 10 aU existina state and local laws and will proc:eecI in aceordance with submitted plans. I am aware lhat the buildinS
:ffici~ cikid5\~~se~~hUtheci~ omc;~ ~~; ;;7?the propaty to perform neG 11070-=1-
Signature Contractor's License No. Dare
Permit Valuation
Permit Fee S
Plan Check Fee $
State Surcharge S
Penalty S
Plumbing Permit Fee S
Mechanical Permit Fee $
Sewer &: Water Permit Fee $
Gas Fireplace Permit Fee S
This Application Becomes Your Buildin& Permit When Apprond
Buildinl!. Official
Dale
Park Support Fee # S
SAC # $
Water Meter Size S/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # S
Water Tower Fee # S
Builder's Deposit S
Other $
TOTAL DUE S
TIlls is to certify thaI the requesl in Ihc above applicalion and accompanying cIocummls is in accordance with the Ci~ Zoning Ordinance and tIlAy proceed as requested. This document
when sisncd by the Ci~ Planner constitutcs a tcmporary Certilicale of ZoninS compliance and aUows construction 10 commence. Before occupancy, a C<TtiflCllte of Occupancy musl he
issued
P1anning Director
Dale Special Coaditiolll, if my
24 hour notice for alllnspettions (~2) 447-98!iO. fax (~2) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372