HomeMy WebLinkAboutBuilding Permit 07-0376
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please ~pe or print and sign at bottom)
ADDRESS
, S S ~ ~ f$ \ ~ ha~<A
57~z/o7
I While
Pink
Yellow
File
City
Applicant
PERMIT NO. 07 - 037,
ZONING (officc use)
PC\SS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
~o~
B",K-ev-
(Phone) GlI';)..-S7C6-jS'77
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone) tor)- -8)- s -&6 '-I r;
(Phone)
ORe-Siding OLower Level FinIsh 0 Fireplace
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration o Utility Connection
f\.e.rla.~
hoC(>;e +9o-.voge_.
I Q....() 0 . " 6
.
CODE: !.R.C. DI.B.c. o Mise.
Type of onstruction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
PROJECT COST IV ALUE
(excluding land)
$
I hereby certlty that I have furnished InformatIOn on thiS applicatHln which IS lLl the best of my knowledge true and correct I also certify that I am the owner or "uthonzed agent tor the
.lonvL'-mcotlOncd property and that all nmstruction wlll conform to allexlstmg state and local laws and will proceed in accordance with subm1tted plans. I am dw,ue that the buildmg
~rlCial ~eT~re, I hereby agree that the City official or a ~eSlgnee may enter upon the propet1y to perform needed ;::':l~S') -0 /
Signature Contractor's License No. Date
Permit Valuation tlZ-S"()O, DC)
Permit Fee $ 7Lf.7S
Plan Check Fee $ ---
State Surcharge $ ,. ~S'
I Penalty $
! Plumbing Permit Fee $
I
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fec $
This Application Becomes Your Building Permit When Approved
I~~
I Buildlllg Um.:ial
b /2,"1..-/0 7
, Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I", $
Pressure Reducer $
Sewer/Water Connection Fec # $
,
Water Tower Fee # $
Builder's Deposit I $
Other $
TOTAL DUE $ [(g,(J 0
I Poid '~M
Date '2.2,/07
I Receipt No. ~'3)}1 S"'
By ~;
ThIS 1S to certify that the requl'st 1Il the above applicatlon and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested ThlS document
when signed by the City Planner cnnstltutcs a temporal)' Certificate of Zonll1g compliance and allows constructIOn to commence Before occupancy, a Certificate of Occupancy must be
Issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9fl50, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372