HomeMy WebLinkAboutDemolition Permit 06-0058
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. 2~. ()~
White
Pink
3 Yellow
File
City
Applicant
I PERMIT NO. 0(, . oose; I
(Please
ADDRESS
/735/
L..AN9F()~ ai-Vo.
ZONING (office use)
LOT
BLOCK
ADDITION
PID 25. 9/0. 02..4-.
LEGAL DESCRIPTION (office use only)
OWNER
(Name)
L./9 LUj P/u),PE;tz.:n(' (Phone)
/Z.6 . /ff /1? rJ-p u: G Le,u
5} 2{)OS
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration o Utility Connection
CODE: DI.R.C. OI.B.C.
Type of Construction:
Occupancy Group:
Division:
~iSC
ORe-Siding OLower Level Fimsh 0 Fireplace
06nOU770!/
A
B
I
E
II
F
1
III IV
H I
2 3
V
M
4
A
R
5
B
S V
PROJECT COST/VALVE $
(excluding land)
I hereby certify that I have furnished mformation on this application which IS to the best of my knowledge true and correct. I also certlly that I am the owner or authorIzed agent for the
above-mentIOned property and that all construction WIll conform to all eXlstlOg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can revoke thIS permit for Just cause Furthermore, I hereby agree that the City official or a deSIgnee may enter upon the property to perform needed mspectHlI1s.
X
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; I"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee I $ "- Other $
$ TOTAL DVE $
Paid Receipt No.
Date By
ThiS IS to certify that th' equest 10 the above applicatIon accompanymg documents IS 10 accordance With the City ZOOlng Ordinance and may proeeed as requested. ThIS document
when signed by the Ci Planner constitutes a temporaty Certificate of Zonmg compliance and allows construcl1on to commence. Before occupancy, a Certlticate of Occupancy must be
issued Iv /' ~
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
") ((1\0 u24, 0
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,Sco'tt County
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"',""~ '..' MINNI;;SOTAOEPAflTMEfIfT OF HEALi10i
WELL AND BORING SEALING RECORD
Minml~"'" SIaIun.8. OhJ;lpIDr 103/
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or W"9CrlOO No.
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Octob~r 22~d. 200 1959
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GI'lOUTING MAT~I^L(Sl)
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