HomeMy WebLinkAboutBuilding Permit 07-0909
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
t
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
OWNER (). (J 1/
(N ame) _f---VI (A ~ 1'0 ts, ~ t v\
(Address) 4-161.-- lUl V\ - alA L/~
BUILDER C . :I:'l 1/ S. LL-c
(Company Name)~ t-tvw) e J?- \..1\\li2-t~ I
(Contact Name) ~ 61\ S i \J ~ Vl~ KA V1
(Address) ~ llfY2- GVlK
Date Rec' d
9, d.-( 07
White
Pin.k
Yellow
I PERMIT NO. 07 0 q 09' I
File
City
AppJicanl
f R-l U1- ~A IL€-
ZONING (office use)
(Phone) q S I . Lflf"1 - S I 7- LL-.
P~lo~ Ltc ~
(Phone) qs l- . L-tt-t () , 1'1 OJ 7
(Phone)
SS 31' 2.-r
TYPE OF WORK 0 New Construction DDeck DPorch e.Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc.
CODE: OI.R.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
m IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST /V ALUE S '<6 z,. 0 0
(excluding land)
1 ht'l"eby cenify that 1 have furnished information on this application which is to the best of my knowledge true and correct, I also cenify that J am the owner or authorized agent for the
above.mentloned propelly and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans, 1 am aware that the building
:ciaJ ct!}effi t~\VOfor just c~use Funhermore, 1 hereby agree that the ci~ orb o~ 0'1:\ "Sy ~ter upon the propelly to perform ~rl q'7;'1'
~a~ Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee S
State Surcharge $
Penalty S
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildinl! Olliei<<1
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ .7&.ov
ThIS is to cenify that the request in the above application and accompanying documents is in accordance with the Ci~ Zoning Ordinance and may proceed a, requested, This document
when signed by the Ci~ Planner constitutes a temporary Cenificate of Zoning compliance and allows construction to commence. Before occupancy, a Cenificate of Occupancy must be
issued
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372