HomeMy WebLinkAboutBuilding Permit 07-0374
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY rONNECTION PERMIT
Date Rec' d
1. White File
2 Pink City
3_ Yellow Applicant
PERMIT NO'6'1_ 3> 14
ADDRESS
\ l.o~-a.
5E.
ZONING (office use)
(2-
LEGAL DESCRIPTION (office use only)
ADDITION p...,e.p,...j~"\ ~LIL
LOT
BLOCK
B(2...;V~L.5 V,......>
3(l1)
l......:> -
PID Z'- - , <;'1 -cu I -c:>
OWNER
(Name)
(Phone)
(Address)
BUILDER, ) _:xl) r - , r illt0
(Name) l A .' '-L) -
(contactName)~T~;t1~~~:' _
(Address) 0 Ref s.~ IV'
(Phone) lo ~ I go ~') c, r (J ~
(Phone)
o New Construction
DPorch
ORe-Roofing
TYPE OF WORK
DDeck
OLower Level Finish
o Fireplace
DAddition
o Alteration
OUtility Connection
o Mise.
PROJECT COST IV ALUE (excluding land) $
I
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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter.. prope 0 perform needed insp ons. ~ ,/,
ao/ h3VC}~ S- OJI /~
Contractor's Lice'nse No. ate '
Permit Fee
$
$
$
$
$
$
$
$
r,z..-
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7~ -
Permit Valuation
'z-
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
,
This
Paid
Date
Jj~:/o'7
I ~~ceiPt No. ;J;;t I~
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