HomeMy WebLinkAboutBuilding Permit 07-0844
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE. .
AND UTILITY CONNECTION PERMIT
l1-YLfO
Date Rec' d
q~ (p. 07
I. While File
2. Piftic City
) Yellow Applica..
(Please type or print IIld sign at bottom)
I ADDRESS
Lfw 11 OC{tW~tcl
I PERMIT NO. 07. 0844t
I ZONING ,..... -I I
L{lli.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER d
(Name) ~'VI' ~ t lr.v: ~
(Address)
J It 50tv
V
(phone)
"lSZ - l{L(O -K .S1'-1
Bun.DER
(Company Name)
(Contact Name)
(Address) 5~lf/
(phone) UG'lt~?J9. "Y3~
.
(phone)
.# 6-StJ 8' ~
TYPE OF WORK D.New Construction DDedc Dporch &:l'Re-Roofing DRe-Siding OLower Level Finish 0 Fireplace
OAcldition DAlteration OUtility Co~ 0 Misc.
. CODE: OI.R.C. OI.B.C.
Type of Ccmstruction: I
Occupancy Group: A B E
Division:
n mIVVAB
F HI MRSU
1 2 3 4 5
PROJECTCOST/VALUE S
(excluding land)
5 I Sf f .,-
I hereby certifY that I have furnished information on this applicallon which is to lhe best of my knowledal! aue and c:orm:t. J also entifY that J am the owner or authorized acent for lhe
above-menl1oned property and that aU consauction will conform to aU existina stale and local laws and will proem! in accordance with submiued plans. J am awan: that the buildinl
;lCiaJ can n:voIc this penni::.9'zse. Furthennon:, I hereby asn:c that the city ;:""OT ; :;;:;.~;- enter upon the property to perform necdedq,hi; '1
Signature Contractor's License No. Dale
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
s
s
s
s
s
s
s
WaterMeter SizeS/S"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
#
#
This Application Becomes Your Buildlns Permit When Approye'
Buildin Official
Dale
$
S
S
$
S
S
S
S
S
TIlls is to cCltifY that the request in the above application and accompanyinl documents is in accordance with the City Zoninl Ordinance and may proceed as reqUl'Stcd. This document
when silned by the City Planner constitutcs a temporazy Certificate of Zoninl compliance and allows consauction to commence. Before OC'CUpancy, a Cl'rtiflCatc of Occupancy must be
issued
Planning DiJm.or
Dale
24 hour notice for all inspections (~2) 447-98!\O, fax (~2) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372