HomeMy WebLinkAboutBuilding Permit 07-0455
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
{A.R. R'?/ A C~ f!'
tP.~.07
I. White File
2_ Pink City
] Yellow Applicant
I PERMIT NO. 07. 04-6.sr
J fONlNG ,..... -l I
'~t'
( ~f
NE"
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
OWNER
(Name)
/?c X I
,
~ I Ail:: $-- /VrLA;2/k ~'
(Address)
(Phone)
~~~~~Name) ;?OI\/€2 6{.. (L.D~ S" (Phone) Ci<:..~/ q~c,- 1900
(Contact Name) LA /ljt.:~D (') A...l (Phone) , to I 2 .3 ~.S- 7 7 7 I
(Address) 28" 0 ~ ' L ( FF 721:> E ~ (A /' N.5 l/U l E Ai A../
TYPE OF WORK 0 New Construction DDeck OPorch
DAddition DAlteration DUtility Conn
CODE: OI.R.C. OI.D.C.
Type of Construction: I
Occupancy Group: A B E
Division:
IT ill IV V A
F HIM R
1 2 J 4 5
OLower Level Fimsh 0 Fireplace
I
S 0' , b-V D ~> trC.-
/
B
S U
PROJECT COST /V ALUE
(excluding land)
I h.....eby certil'y that I have furnished information on this application which is to the best of my knowledge true and correct. I also certil'y that I am the owner or authonzcd agent for the
above-mentIoned property and that aU co . w' 0 aU existing state and local laws and wiD proceed in accordance with submitted plans. I am aware that the buUdmg
officlal can :evok~5 just ca e. Furth agree lhatthe CIty official or a deSign~e may enter upon the property to perform needed~ons. .
X 2,s-'6' 8~Lt 7
. Contractor's License No. ate
Permit Valuation
Pennit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
Building Ollicial
Dale
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 $
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 signt-d by the City Planner constitutes a temporary Certificate of Zoning compliance and aUows construction to commence. Before occupancy, a Ct'TliflCatc of Occupancy must be
issued
Planning Director
Date Special Conditions. if any
24 hour notice for all inspections (~2) 447-98~, fax (~2) 447-424!l
16200 Eagle Creek Avenue Prior Lake, MN 55372