HomeMy WebLinkAboutBuilding Permit 07-0862
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
q I G' . Ll 1
File
City
Applicant
I PERMIT NO.
01. fj" "y
] White
Pink
Yellow
ADDRESS
I
t'foSiwoc/j
IlJ i"" .
/J~ 'Vf'
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
OWNER
(Name) Bo&
LAtfso~
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
$~~/t1J~ ~Il/S r:
.:r,4501f.} 5 U4~~I/U~
UI~2
(Phone) 9S-;;1. - ~ 9 ~ - S-& g ('
(Phone)
~L(/.d.. vor<4A/v
TYPE OF WORK 0 New Construction ODeck OPorch Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlon OAlteration OUtility Conne tIon
CODE: OI.R.C. OI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
o Mise
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I have hlrmshed InformatHln on this application whIch IS to the best of my knowledge true and colTect. I also certdy that I am the owner or autho!lzed agent IlJr the
,lbove-menttoned propCl at all Cllnstr 'Ill c . stmg state and local laws and will proceed In accordance with submItted plans I am aware that the budding
nft1cial can rc 1lS permit for . e Furt ). re, I hereby agree th t the CIty official or a deSIgnee may enter upon the prOpeJ1y to perform needed lI1Spectlons
':>'00 <;99?:J 9/'0/07
Contractor's License No. ' rfate
x
Park Support Fee
SAC
#
#
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Iluildlllg Urtlclal
Datc
$
$
$
$
$
$
$
$
$
.....-
ThiS IS to c('[tlfy that the request m the above applicatlOll and accompanYing documents is 111 accordance with the City Zoning Ordinance and may prDcl'cd as requcsted ThiS document
when signed hy the City Planner Cllllstltutes a templ)raI)' Certificate of Zonmg complIance and allows construction to commence. Before nccupancy, a entltle.lte llf Occupancy must be
issued
Planning Director
Date
24 honr notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any