HomeMy WebLinkAboutBuilding 06-0894
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
10,3. 0,"
n at bottom)
A Y(j){r\
Ave.
,;
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. ~. BCJ4-
ZONING (officc usc)
PID 65:.
dr{"O
OWNE~
(Name) ell.l\
KloSf(uV
(Phone)
c,1J ":7og
/j7L
(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
OAdditlOn OAlteration OUtility ConnectIOn
CODE: OLR.C. OLB.C. o Mise.
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 (excluding land)
Division: I 2 3 4 5
I hereby certify that I have turmshcd mformation on this applicatIOn which IS to the best of my knowledge trut..' and correct I 111so certify that I am the owner or iluthonzcd agent for the
JboVe-mentlllned property and that all constr won WI conform to all cXlStmg state and local laws and will proceed m accordancc with submItted plans 1 am awarc that the blllldmg
ofticial can r' ke tlm per t Jr Just ,se urthcr re, I h?l"l'by agrec that the CIty official or a deslgncc may enter upon the proper1y to pertlJrm needed mspectlons
X
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
Iluilulng Ufliclal
Datc
Contractor's License No.
Date
# $
# $
$
$
#
#
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
ThIS IS to certIfy that the request II1 the above applicatwn and accompanYlllg documents is 111 accordance with the City Zoning Ordinance and may procced as requested ThiS document
when signed by the City Planner constitutes a tcmporary Certificate of ZOl1lng compliancc and allows construction to commence Before occupancy, a Certificate of Occupancy must be
i.ssucd
Planning Director
Special Conditions, if any
Date
24 hOllr notice for all inspectiolls (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372