HomeMy WebLinkAboutBuilding 06-0895
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CITY OF PRIOR LAKE BUILDING PERMll,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
n at bottom)
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Date Rec j d
10. .3 () 0
White
Pink
Yellow
I PERMIT NO. Or::. () 8tjS I
File
City
Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
5k4T
(Address) 5Ad""~
(Phone) 7~:J - ;""?t2 - tf # ~
i BUILDER ~ Ai
I (Company Name) l/tJ -( -f / IJf/L. I ~
I (Contact Name) P -'9/1/ rJ
(Address) <t
TYPE OF WORK 0 New Construction DDeck DPorch
DAddition DAlteration DUtiJity Conn
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
II
F
I
IV
I
3
V
M
4
I
E
III
H
2
(Phone)
(Phone)
?~3...5~/-bgc/i
DLower Level Finish 0 Fireplace
o Misc.
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
x
I hereby certify that I have hlrmshed Information on this applicatIOn which is to the best of my knowledge trut' and correct. 1 also certify that I am the owner or authorized agent for the
abovc-mentlOned property and that all Clll1structlOn Will COnllJrm to all eXlsllng state and local laws and Will proceed in accordance with submitted plans. I am aware that the buildmg
"fticial can reVll -c thiS perml! I,ll' J 1St cause rthermore, I h 'by agree that the CIty llffieial or a deSignee may enter upon the propelty to perllJrm needed mspectl<lI1s
&~~M:l)&b /a/3'?~
Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee I $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
lluildlllg Umclal
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8",1", $
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # $
Builder's Deposit I $
Other $
TOTAL DUE $ ?&:>. () 0
ThIS IS tll certify that the request m the above applIcatIOn and accompanymg documents IS m accordance With the City Zllning Ordinance and may pmceed as requested TIllS dllcumcnt
when signed by the City Planner cnnstltutes J temporary Certificate of Zomng compliance and allows construction to commence Before ()ccupancy, a Certificate l)f Occupancy mllst be
ISSllt.'d
Planning Director
Special Conditions. if any
Date
H hour notice' for all inspcctions (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372