HomeMy WebLinkAboutBuilding Permit 07-0368
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (ofIice use only)
LOT
BLOCK ~ ADDITION
OWNER
(N ame)
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(Address)
Date Rec' d
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Pink
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File
City
Applicant
I PERMIT NO. 61 ....'2fo6
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(Phone)
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i BUILDER
I (Company Name)
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I (Contact Name)
(Address)
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TYPE OF WORK 0 New Construction ODeck o Porch ~e-Roofing ORe-Siding OLower Level finish 0 fireplace
OAddition OAlteration OUtility ConnectIon
CODE: DI.R.C. DI.B.c. o Mise -~---
Type of Constmction: I II III IV V A B PROJECT COST IV ALUE $~ LIC()C~-
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5 (excluding land)
I hereby certify that I have turmshcd mformation on this application which is to the best of my knowledge true and correct. I also certIfy that I am the ownn or authl)flzed agent for the
abllVl'-mentwned property and that all Clm,tructwn Will contlJrm to all eXlstmg ,tate and lucallaws and will proceed in accordance with submitted plans I am aware that the buildmg
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Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
L..~ 0 0
.."
s Your Building Permit When Approved
~/~~(}7
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connectton Fee # $
,
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ /~0
I RecCi~O ~ ~30<)
By t+
Paid
Date
-7~ --
';
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ThiS IS to certify that the requl'st 111 the abuve applICation and accompanYll1g documents is 111 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
\\'hell signed by the City Planner cunstltutcs a temporary Certificate of Zonll1g compliance and allows constructiuI1 to commence Befure occupancy, a Ccrtlticatc of Occupancy must be
issLled
Planning Director
Special Conditions. if any
Date
24 honr notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372