HomeMy WebLinkAboutBuilding Permit 07-0746
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CITY OF PRIOR LA.KE RUILDINC PIBl.MIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
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ADDITION
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OWNER
(Name)
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(Address)
BUILDER
(Company Name)
(Contact Name)
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PERMIT NO.O?- 071../(0
File
City
Applicant
ZONING (office use)
(Phone)
'52 --?ss- Y'us y
(Phone)
(Phone)
1\'-z - 7YC.. :5 (JC{ '-
75; L '-- '777', rcrv <"'
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TYPE OF WORK 0 New Construction ODeck OPorch ORe,Roofing ~Re'Siding OLower Level Finish 0 Fireplace
OAdditIon OAlteration o Utility Connection
CODE: ~.R.C. DI.B.C. o Mise.
Type of 0 stmction: I II III IV V A B PROJECT COST /V ALUE $ /0 Ol;0 ~
Occupancy Group: A B E H I M R S U ...
Division: 2 3 4 5 (excluding land)
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I hereby certify that I have turOlshed mimmation on this apphcatlOn which IS to the best 01 my knowledge true and mITect. I also certlly that I am the owner or aut!1ul!ze,1 agent tor the
clhnvc-mCl1tlOl1cd property and that all Clmstruction will conform to allexistmg state and local laws and will proceed In accordance with submitted plans_ I am aware that the buildmg
ofticial can r' l' tl11S ptTmlt fl.H cause Furthermore, I hereby agree that the City official O[ a deSignee may enter upon the prOpclty to perform needed mspcctlJlI1S
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Signature
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Contractor's License No.
Date
Permit Valuation 2500,00
Permit Fee $ 74, 7S-
Plan Check Fee $ - -
State Surcharge $ , . 2_S-
I Penalty $
I Plumbing Permit Fee $
~echanical Permit Fee I $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
This Application Becomes Your Building Permit When Approved
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I Bulidlllg Urticlal
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Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7~,OO
Paid
Date
Receipt No.
Sy
ThlS IS to certify that the request in the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may prllcl'cd as requested ThiS dllcumcnt
when SIgned by the City Planner constItutes a tempor<llY Certificate of Zomng comphancc and allll\\!S construction to commence. Before lKcupancy, it Certificate of Occupancy must be
I i"isLlcd
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) "47-9850, fax (952) ....7-..245
4646 Dakota Street Prior Lake, MN 55372