HomeMy WebLinkAboutBuilding Permit 05-1163
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
I White
Pink
J Yellow
File
City
Applicant
I PERMIT NO. ()~ -llh3 I
(office use)
Uf2Mo(!;-- ~
LEGAL DESCRIPTION (office use only)
LOT
BLOCKL-
ADDITION
<..,...L,S
l~Mn
PID
2- -z84-oL')'-o
OWNER
(Name)
~L~6Il-r
~e-
b,2G~
j (L..
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level finish 0 Fireplace
OAddition o Alteration OUtility Connection
CODE: DI.R.C. DI.B.c. o Mise. O~IY\O /+Do50-
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $ (]
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5 (excluding land)
I hereby certily that I have furnished mfmmation on this applicatt which is to the best of my knowledge true and correct. I also certIfy that I am the owner or autho!lzed agent for the
abllve~mentlOned property and that all const~r;ill conform 0 all existIng state and local laws and will proceed in accordance with submllted plans. I am awa. re that the buildmg
:'flClal can re e thl( per mil for Jl:s~se t14oe~reb agree th~lty official or a deSIgnee may enter upon the propel1y to perform needed mspectIons
Signature Contractor's License No. Date
Builder's Deposit
Other
#
#
Permit Fee
$
$
$
$
$
$
I $
$
Park Support Fee
SAC
Permit Valuation
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee"
Water Meter Size 5/8"; 1",
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
TOTAL DUE
Paid
Date
Receipt No.
By
ThIS IS to certlly that the request In the above applicatlon and accompanYIng documents IS In accordance with the City Zoning Ordinance and may proceed as requested. TIllS document
when signed by the City Planner constItutes a temporal)' Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certlficate of Occupancy must be
isslIcd
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