HomeMy WebLinkAboutBuilding Permit 07-0744
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CITY OF PRIO!t LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE. .
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. Wbite File
2. PinIc City
) y.llow Applicanl
?h (0 7
I PERMIT NO. 07- 07'1 'I
(Pleue type or print IDd sign at bottom)
lADDIES'
1'7000 TOV'O>tfo A~
I ZONING '....-l I
.hE
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID
e.O.D~S- cJ
OWNER. , ... d
(Name) M , /te. <I- Dc /1\ " ~ e /IA ttJ'S I d .f
(Address)
(Phone) (q tj 2) If t.f7 - ljl6 2
BUILDER
(Company Name)
(Contact Name)
(Address) 5&'1/
(phone) 1.16/''//;9. "I3XJ
(phone)
~5L18 .;L
TYPE OF WORK DNew Construction DDedc OPon:h -Rooting ORe.Siding OLower Level Finish 0 Fireplace
OAddition OAlteration DUtility Connection 0 Misc,
~', oqq.
/
. CODE: ~.R.C. OI.B.C.
Type of Ccmstruction: I
Occupancy Group: A B E
Division:
n
1
PR.OJECT COST/V ALUE S
(excludiDg land)
mIVVAB
HIM R S U
2 3 4 5
x
I bm:by certify that I have furnished information on this application which is to Ihc best of my knowle. true and eorrect, I also certify that I am the uwn~,. or authorized agent for the
above-menbOned propeny and that aU construction will conform to aU existina stale and local laws and will proceed in aeeordarn:e with submitted plans, I am aware that the buildinB
officiaJ can revoke this p 't for just cause. Furthermore, I hereby aFCC that the city officiaJ or a designee may enter upon the property to perform needed Inspections.
,~ ~,)'i#i'? g /,/07
SignatuIe Contractor's License No. Dau:
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer &: Water Pennit Fee
Gas Fireplace Permit Fee
Park Support Fee # $
SAC # S
Water Meter Size 5/8"; I"; S
Pressure Reducer S
Sewer/Water Connection Fee # S
Water Tower Fee # S
Builder's Deposit S
Other S
TOTAL DUE S ?(P,OO
$
S
S
$
$
S
S
S
.25
This Application Becomes Your Buildins Permit When Approycd
~ ~ ~(9/CJ7
Buildin2 Official Dille
I ~18f;~
(01
I Receipt No. z::;-i/ ~2. /
By 13
r
nlls is to certify that the request in the above application and accOmpanyinB documents is in aceordanee with the City Zoning Ordinance and may proceed as requ~'Sted. This document
when signed by the City Planner constitutes a temporary Certillcate of ZoninB compliance and aUows construction to commence. Before occupancy, a CertifICate of Occupancy must be
issued
Planuing DiMctor
Date SDCCiaI CoaditiOlll, if mv
24 hour notiee for an inspections (~2) 447-98~, fax (~2) 4474245
16200 Eagle Creek Avenue Prior Lake, MN 55372