HomeMy WebLinkAboutBuilding Permit 07-0621
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE. .
AND UTILITY CONNECTION PERMIT
I ~e~;::rX')~
~: ':::' ~::y I PERMIT NO. 07. 0&2- I
) Yellow Appliconl
UrIVf') SE
I WNlNG '''''''-l I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Phone)
q')~-adia -4&SLL I
I OWNER '12. - ,~ TI . ,
=~Olr\er
=~ Name) ~~.n~ liv"cm/ It/>(( IrlLlt7()Q
(Contact Name) &:" t.(]
(Address)6&l// ;1;~m()r/d/ . if. ?h' 'tUttla-
PID zs: s/7. Oz.s: 0
(phone) uGl'~?;9.~3X)
(phone)
,IV' 5- 5tJ 8' aJ-
TYPE OF WORK O,New Construction DDeck OPorch ~.Roofing ORe.Siding OLower Level Finish 0 Fireplace
OAddition )'tAlteration OUtility Connection 0 Misc.
CODE: OI.R.C. OI.B.C. PR.OJECTCOST/VALUE S Ll9 j'1~ L./O
Type of Construction: I n ill IV V A B (excluding land) ~
Occupancy Group: A B E F HIM I. S U
Division: I 2 3 4 5
I hereby certify that I have furnished information on this application which is 10 lhe best of my knowledae true and correct. I also certify thaI I am the owner or authoriZl.'d aFnt for the
above-menboned property and that all eonstruction will conform to all existina stare and local laws and will p:oceed in accordance with submilled plans. I am aware that the buildinS
official can revoke this permit for just cause. Furthermore, I hereby asree thaI the city official or a designee may enler upon the property 10 perform needed llI.pections,
X ,. ~ ptJ ~f ;;-j/'si/ Ih,~Jo7
Contractor's License No. ~ Dare
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Pennit Fee $
Gas Fireplace Permit Fee $
'Ibis Application Becomes Your Buildinl Permit When Apprond
Buildinl!. Official
Date
Park Support Fee # $
SAC # $
Water Meter Size S/8"; l"j $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7& .() 0
TIlls is to certify thaI the request in the above application and accompany inS documents is in accordance with the City Zonins Ordinance and may proceed as requL'Stcd. This document
when sisned by the City Planner constitutes a temporary Certiftcate of lonins compliance and allows construction to commence. Before occupancy, a CLTtiftcatc of Occupancy must be
issued
Planning Dim:tor
Dale Special Coaditions, if lilY
24 hour notice for all inspections (~2) 447-9850. fax (932) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372