HomeMy WebLinkAboutBuilding Permit 07-0892
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF WNING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
q/ t~1 O.:f
I. White Fil.
2. Pink City
) Yell_ Applic:a11l
I PERMIT NO. 07 -~/1'L I
I I ZONING c--> I
lft~~;: ~ ~d ~7r
LEGAL DESCRlPTION (offICe use only)
LOT:3 BLOCK
ADDITION
PID 2S' Ooer .()17, t:J
OWNER ,/? A A~.
(Name) ~~
(Address) litO
(Phone)
qG'L-~:r. :44b~
~.~.
BUD..DER ~; (;>
(Company Name) ;.,;, l' ~
(Contact Name) I on/) UIJ'1H?,),J v
(Address) -1,aX:) C rC- l;tf,-
TYPE OF won 0 New Construction DDeck OPorch e.Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration DUtility Connection 0 Misc.
. CODE: 19ri.R.C. OJ.B.C.
Type of~~on: (II
Occupancy Group: A B E
DiyisioG: 1
m IV V A B
HIM R S U
2 3 4 5
x
information on !his application which is to the best of my knowledge true and correct. I also certifY that I am the ownc:r or authonzcd aJll,'IIt for Ihr
all COIIStroctlon will conbm to aU existilll statt and local laws and will proceed in accorclana: with submittrd plans. 1 am aw;m: that the buildiJll
sr. urthermore, I hereby aaree that the city official or a drsipJer may enter upon the property to perform needed ~ion5.
lO'l, ~1?? -Z 15 q Ilal t);f-
hUe Contractor's License No. Date
I hereby cenify tbal I have rum.
above-mentioned a
official can revoke t .t
.
Permit Valuation .. 7.500,00
Pennit Fee S ' 7q~ 7<::
Plan Check Fee S -
State Surcharge $ '.2S-
Penalty $
Plumbing Pennit Fee S
Mechanical Permit Fee S
Sewer & Water Pennit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your BuBcUna Permit When AppI'OYed
~~ -- ~ ~
Buildin2 Official
9/18/07
'Date
1 goo ..--
PROJECT COST IV ALUE S
(excluding land)
Park Support Fee # $
SAC # S
Water Meter Size 5/8"; )"; S
Pressure Reducer $
Sewer/Water Connection Fee # S
Wa~rTowerFee # S
Builder's Deposit $
Other $
TOTAL DUE $ 7(P ,tJ e
I Paidlf?(i/"
Date fie 7
I~.g; S",,,S"tl
ThIS IS to crrtify that the requrst in the a\llM! application and accompanyinl documents is in accordancr witb the City Zonina Ordinance and may proceed as reqUl.'StCd. This document
when signed by !he City Planner constitutes a ttmporuy Crrtiflcate of Zonina compliance and allows constrUction to commence. Before occupancy, a C~'ttirJCatt of Occupancy must be
issued
Planning Dim:tor
Date
Spedal Conditions, if any