HomeMy WebLinkAboutBuilding Permit 07-0406 (2)
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
52-f-C7
(Please
ADDRESS
IV (;I /G.;j7-7jV c:7lJ .0
/(,-2 73
1 White
Pink
Yellow
File
City
Arplicant
I PERMIT NO. 0 7. ()~0
ZONING (office lIse)
~,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER A
(Name) .J 1>0/ i- C.I,4f/b //,/Z-/)t: /2 j" ~/V
(Address)
PID Zs:. !4-1 .04-3.0
(Phone)
q)2 . 7"~(::>. 18?~
BUILDER ~ ~ /'
(Company Name) I2cvr C-O,4?//4,z,y ~4
(Contact Name) [I} /<'41l~tv
'7 ~()" "1Ot.-u t/1 0/2,
r~c.
(Phone) '765 r -S-~o. d/~.."
(Phone) .II? 70:J-- ,. 3 ~ -,
c;- c ~<r c'
(Address)
,4? ~ 01'/2..--4 ~ ---
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level finish 0 fireplace
OAddition OAlteration o Utility Conne tlon
CODE: OLR.C. OLB.C. o Mise
Type of Constnlction: 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
l hereby certify that I have hlfm.shcd mfnrmatlOn on this application which IS to the bcst of my knowledge true and cotTect. 1 also certify that I am the owner or <luthoflzed agent for the
JbllVc-mentlOned property and that all cnl1strllction will conform to allexistmg state and.locallaws and will proceed in Clccordancc with submitted plans I am aware that the buildmg
llllicial can fevllkc thiS ptTmlt for Just cause Furthermore, 1 her' c cay official or a deSIgnee may enter upon the prop(,11y to perform needed lI1SpCCtlOI1S
~ l:)-..2~ '07
x
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
Mechamcal Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $ I
This Application Becomes Your Building Permit When Approved
lluildlllg Unicial
Dak
Contractor's License No. Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; ]"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit i $
Other
TOTAL DUE
.!J3iPerl
ThiS IS to certify that the request 111 the abl)\'l' application and accompanYll1g ducuments IS III accordance with the City Zoning Ordinance and may proceed as requested ThiS dl)('Ufficnt
when signed hy the City Planner constitutes a temporal)' Certificate of Zomng compliance and allows constructIOn to commence Befure occupancy. ,1 Certificate of Occupancy must be
),'isllcd
Planning Director
Special Conditions, if any
Date
24 hour notice for all iuspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372