HomeMy WebLinkAboutBuilding 06-0988
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
File
City
Applicant
I PERMIT NO. ~ -<:( bt6
White
Pink
Yellow
J1x/f}/f- t:.~ c
u.
LEGAL DESCRlPTION (office use only)
LOT
PID "2
BLOCK
ADDITION
OWNER.
(Name)
;(;t.hAK.tJ
~ ".,..,tt
fJu/J/9~
(Phone) 75;/.- ~6 - ::l. /-'3
(Address)
BUILDER 7. /
(Company Name) lA.../E"S / lA .<.. fV
(Contact Name)
(Address) 7700- /3;rA'
ZONING (office use)
p( Sp
-280
O ">~,
/IU
(Phone) /63-591-03 d?'
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility ConnectIOn
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
u
PROJECT COST IV ALUE $ C; 9 1- ~ J ~
(excluding land)
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S
,
I hereby certify that I have furnished mformation on this applicatIOn which IS to the best of my knowledgc true and correct. I also certIfy that I am the owner or authonzed agent for the
above-mentIOned property and that all construction will conform to all eXlstmg state and loeallaws and will proceed in accordance with submitted plans I am aware that the buildmg
:ficial can revoke this permll for ust cause F rmore, I hereby a e that the CIty of&a ~i:~;y;;;n;;e propelty to perform ne:~::?:'~6'
Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $ L 2-~
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee" $
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
Paid
Date
i~rio/~
. (
I Receipt No. ~2..~(:S
By (lJ)-
$
$
$
$
$
$
$
$
$
b.-
ThIS IS to certify that the request m the abllve applical10n and accllmpanymg documents IS In accordance WIth the City lllning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner constllutes a temporary Certificate of lonmg compliance and allows construction III Cllmmence. Before llccupancy, a Certlficate of Occupancy must be
issucd
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