HomeMy WebLinkAboutBuilding Permit 07-0927
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
42 ~7
n at bottom)
G r o../A l.-.f 0' <J C.
c,"r
Date Rec' d
C(.z107
White
Pink
Yellow
~:~y I PERMIT NO. 0 7 _ 012- ~
Applicant -IJ
Pr( Ur h/le
ZONING (office use)
14 IV
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address) ;?d
Cw-J ,'n.'I. t exr_
I -e fry
/ ",lr, y) I:>
<; h '1 ri rJ r'''<'" --c
m/'l...l
(Phone) 44J! RG 3J'
(Phone)
h-i;-j 7'}
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 FIreplace
OAdditIon OAlteration OUtility Connec IOn
CODE: OLR.C. OLB.C.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
o Mise.
B
S
PROJECT COST IV ALUE
(excluding land)
$
U
I hereby certify that I have turnished mformatIOn on this application which is to the best of my knowledge true and correct I alsu certify thilt I am the owner or iluthorlzed agent for the
above-mentIOned property and that all ellnstruetlOn Will confiJrm to all eXIStmg state and local laws and Will proceed in accordance with submitted plans. I am aware that the blllldmg
()tTicial can revoke thiS permit for Just cause Furthermore. I hereby agree that the City official O[ a deSignee may enter upon the propelty to pertc)rm needed inSpectIOns
~ ~~7~7
x
~
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
I
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $ i
This Application Becomes Your Building Permit When Approved
lluildlllg Unlcial
Date
Contractor's License No.
Date
Park Support Fee
SAC
#
#
Water Meter SizeS/8"; I";
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE
-
ThIS IS to certIfy that the request in the above applicatHm and accompanY1l1g ducuments is In accordance with the City Zoning Ordinance and may prucecd as requested ThiS document
when signed by the City Planner C(mstltutes a temporary Certificate of Zonmg compltancl' and allows constructIOn to commence Before uccupancy, a Cl'rtlticatl' tlf Occupancy must be
i."islIcd
Planning Director
Special Conditions. if any
Date
24 hour notice for all inspections (952) 447-91150, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372