HomeMy WebLinkAboutBuilding Permit 07-0600
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date !tee \ d
White
Pink
:l Yellow
File
City
Applicant
I PERMIT NO. 07.-tJfd:Jo
ZONING (office use)
f4$0
Sf
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID "'Z. -;-. /38 r()2 I -0
OWNER
(Name)
t:...."t
I 'f 1/
Elr,'c 5cy...
(Phone)
612 - f{16 - ~9 ff"
(Address)
,....: I
S'E
BUILDER ~ Lo "\. S J.
(Company Name) J \.(100. <) -J-,. ,'/.I f^ C,
(Contact Name) ..JIY"'\ S.~.'y.s
(Address) ~I 0 C.., (2..,) 33 ,V i..J Gft'iI'-
(Phone)
(Phone)
<1J ,) -;)..5 c;- ,. JOy t:>
1J,L -;"s7-S03t>
~
TYPE OF WORK 0 New Construction OOeck OPorch "gIRe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditIon OAlteration OUtility ConnectIon
CODE: ~.C. DI.B.C. o Mise.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $ 6 OOt> . tX)
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 hlrnlshed ml,)rmation on this applicallon which IS to the best of my knowledge true and correct. I also certify that I am the owner or authollzed agent tor the
Jbove-mentIOned property and that all construction will conform to allexistlng state and local laws and will proceed In accordance with submItted plans 1 am <lwarc that the buildmg
()tficial can revoke lIS crmIt for Just cause Furthermore, I hereby agree that the Clty official or a designee may enter upon the propelty to perform needed inSpectIons
x
.;2.0 l <j r , t!) I
Contractor's License No.
7 - Ie) ~ 0 '7
Date
Permit Valu
'-:2-
Park Support Fee
SAC
#
#
$
$
$
$
Permit Fee
$
$
$
$
$
$
I $
$
(...z-~
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
$
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Tower Fee
Builder's Deposit
Other
Paid
Date
11';1
$
$
$
$ -, 0- -
I ReceiPtNo.~4-b
..By M_
,
Sewer & Water Permit Fee
TOTAL DUE
ThiS IS to certlty that the request in the above appJicatLOI1 and accompanymg documents is 111 accordance with the City Zoning Ordinance and may prncl'cd as requested ThiS document
when signed by the City Planner constItutes a temporary Certlticate of ZLlnmg compliance and allows CtlI1strUrllon to commence Before occupancy. a Cellllicate of Occupancy must be
Isslled
Planning Director
(
Date
24 hour notice for alllllspcetions (952) -t-t7-9850, fax (952) -t-t7--t2-t5
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any