HomeMy WebLinkAboutBuilding Permit 07-0414
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
n at bottom)
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5+ 5t-
Date Rec' d
S. 30. 0 7
I White
Pink
Yellow
File
City
Applicant
PERMIT NO. 01. 0 -1-1-1-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
~l.I;^ C \ v~c) ( l : I:--
(Address)
PID 2S-. .5 (J 2-. 0 G 7 _ iJ
(Phone)
1S';2,__I/Lf7-glllf1
i BUILDER
I (Company Name)
I
I (Contact Name)
I (Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level FinIsh 0 FIreplace
OAddil1on OAlteration o Utility Connecl1on
CODE: OI.R.C. OI.B.C. o Mise.
Type of Constmction: I II III IV V A B PROJECT COST /V 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 turmshed mt(lrmatllln on this application which IS to the best of my knowkdge true and correct. I also certIfy that I am the owner ()[ authOrIzed agent t(l1 the
above-mentIoned pro perry and thaI all construction WIll cont(Jrm to all eXlstll1g state and local laws and will proceed rn accordance With submItted ptans I am aware that the blllldrng
offiCial can revoke t~1crmlt I()r jU'i! ca{''} FUfheJmore, I hereby agree that the Clry official or a deSIgnee may enter upon the propelty tD perh1rm needed lI1SpeCllDns
\ \AM'\- C t~ :5 - 3 t9 --07
X ~
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
,
~echanical Permit Fee $
Sewer & Water Permit Fee i $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
lluildll1g Omclal
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7&- (j 0
~7~/
ThiS IS to certify that the request in the abllVl' application and accompanymg documents is 111 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner (()I1stltutcs a temporary Certificate uf ZOI1mg compliance and allows constructIOn to commence Before llCcupancy, a CertIficate of Occupancy must he
issued
Planning Director
Special Conditions. if any
Date
24 hOllr notice for all inspections (()52) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372