HomeMy WebLinkAboutBuilding Permit 07-0948
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
10. "1_ 07
File
City
Applicant
I PERMIT NO. 07. or~1
White
Pink
Yellow
(Please
ADDRESS
3&90
w/'-'~oW t?f//TUf ~ .-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name) -,?~ r.-
(Address) .:g
.
=Ml') ~//V (Phone) 7 ~ J . 'I G.L/- 'Irq. 7
/ 8 B l' tin' #A- .q ~-tf'.s .-
(!) A EAJ.P~ /c cJJ . f3,:lFAJlo
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Fil11sh 0 FIreplace
OAdditlOn OAlteration OUtility Conne 10
CODE: OI.R.C. OI.B.C. o Misc.
Type of Constmction: 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 formation on thIS application which IS to the best of my knowledge true and correct. I also certify that I am the owner or authollzed agent IlJr the
Jb<lvc-mcntlo property and that all constructlo I conform to all eXlStll1g state and local laws and will proceed in accordance with submitted plans. I am aware that the buildll1g
~liClal ean I' voke thIS pClmJt for Just cause FurtH y agree that the City official or a deSignee may enter upon the propel1y to pcrhJrm needed Ild~ctl~so 7
Contractor's License No. Date
Permit Valuation
Park Support Fee
SAC
#
#
Permit Fee
$
$
$
$
$
$
I $
$
TOTAL DUE
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
Water Tower Fee
#
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace PermIt Fee
This Application Becomes Your Building Permit When Approved
lllllldlllg Ufficlal
Datc
$
$
$
$
$
$
$
$
$
ThiS IS to ('crtily that the request in till' above applicatIOn and accompanYll1g documents IS 1Il accordance with the City Zoning Ordinance and may pnlcL'L'd as requested ThiS dDcumcnt
when signed by the City Planner constltutes a temporal)' CertifIcate of Zoning compliance and allows construction to commence Before llcclIpancy, it CertIficate of Occupancy must be
isslIed
Planning Director
Date
24 hOllr notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any