HomeMy WebLinkAboutBuilding Permit 07-0884
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
{jilt
c -7
1 White
Pink
Yellow
File
City
Applicant
I PERMIT NO. (,] 0884--j
(Please n at bottom)
ADDRiS:;,,21 8;ta It L
ZONING (office use)
t;;I V' /L ;---
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
(Phone)
(Address)
(Phone) 9.fz- <f "-10 5::; I <j
(Phone)
L.
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditIon OAlteration o Utility ConnectIon
CODE: DI.R.C. DI.B.c. o Misc.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certify that l have furnished mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or ;llIthonzed agent for the
Jb()vt'-mentlll~ed prnperty and tl t all cn~tlnn will contlJfm to all eXisting state and local laws and will proceed In accordance with submitted plans. I am aware thJt the bUilding
~trCl'll CJn revnke tIllS permit t =ause rthermore, I hereby agree that the Clty olliClal or a deSignee may enter upon the propelty to perform nge7~no ~
re Contractor's License No. Date
Bulldlllg Urtlclal
Date
Park Support Fee
SAC
#
#
Permit Valuation
Gas Fireplace Permit Fee
$
$
$
$
$
$
I $
$
Water Meter Size 5/8"; I";
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Sewer & Water Permit Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
ThiS IS to certify that the request in the above applicatIon and accompanYlllg documents is in accordance with the City Zoning Ordinance al may pn)cl'l'd as requested. ThiS dpcuml'nt
v..hCI1 signed by the City Planner constItutes a tempurary CertIficate uf Zonmg compliance and allows construction to commence. Before occupancy, a CCl"tlticatl' l)f Occupancy must be
ISSlled
Planning Director
Date
H hour notice for all iuspectious (952) ~~7-985(). fax (952) ~~7-~2~5
4646 Dakota Street Prior Lake. MN 55372
Special Conditions. if any