HomeMy WebLinkAboutBuilding Permit 07-0735
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CITY Of PlUOR. LA.KE RUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
e. 7_ 0'7
File
City
Applicant
I PERMIT NO. 01 o 73S-1
White
Pink
Yellow
(Please
ADDRESS
n at bottom)
I~ /94-
L-/llt.hJ I LJ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID 2~. 0941.0 ( (1. (
BLOCK
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(c, )1 )
hL L'-/;J/~- E"E'<;~.IL$"
7/m IJ/4I//,aJ-OA'
(Phone)
(Phone)
sn> n-
I(fTI- 91()()
TYPE OF WORK 0 New Construction ODeck OPorch RtRe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration o Utility Connection
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
1
III
H
2
IV V
I M
3 4
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I herehy certity that I have turmshed mfmmatlDn on this appltcatlOn which IS to the hest of my knowledge true and correct I also certIfy that I am the owner m authol1zed agent tm the
ab(lVl'-mcntlOI1cd property and that all construction will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans_ 1 am aware that the buildmg
()llicial can revoke thIS ptTmlt for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the propelty to perform needed mspcctlol1s
X _~~ ~-7-07
19nature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
lluildlllg OffiCIal
Date
$
$
$
$
$
$
I $
$
$
ThiS IS to certify that the request in the above applicatlOl1 and accompanymg documents is In accordance with the City Zoning Ordinance and may proceed as requested TillS document
when signed by the City Planner CLlI1Stltutcs a temporal)' Certificate of Zomng complIance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any