HomeMy WebLinkAboutBuilding 06-0876
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
5# C/
cLC=
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID<) "7LJ ()(5)..
OWNER ..,
(Name) ,~.#:/fWN
(Address) / 'I J
Date Rec' d
#C
1 While File I PERMIT NO V ~
i ~;I~w ~~:hClm .C)~'- f '7 fV'
I ZONING'__l I
~D
\ 7& /t/# / /::'L:=YP
.- /f) ~
&-U )/EV (Phone) ('152) Z 33 -54- / L./
.
BUILDER
(Company Name)
(Contact Name)
(Address) 41r
/;I/c=,('/~>r JZt:A0V-HOC7'\,./'
<-'Y.50/l/ He: u~ry
W5s.r 2/VG..--e ~~/
(phone) (7(,J) Z yo.> - 773 Z-
(Phone) (?, J) z z 7 - Z ;:tJ ?
~A/77~. )I"1-1A/ 5 (; Z-
TYPE OF WORK 0 New Construction ODeck OPorch ORe. Roofing
o AdditIOn OAlteration OUtility Connection 0 Misc.
CODE: OJ.R.C. OJ.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
n
F
I
ill IV V A
H J M R
2 3 4 5
OLower Level Fimsh 0 Fireplace
.,?'tJ
-
B
S U
PR.OJECT COST /V ALUE S /5, /'Olf
. ,
(excluding land)
I hl'!"eby cenify thaI I have furnished Information on this application which is to the best of my Icnowledge Due and correct. ) also certify lhat I am the Uwnl'!" 0.. authonzed agl'1lt for the
above.mentloned propt'lty and that aU conslI'Uction will conform to aU existing state and Jocallaws and will proceed in accordana: with submitted plans. I am ilWilrc that the buildmg
:fficial c Ice this per it for just cause Furthermore. ) liIee thatlhe city omcia~;0 ~ ~ jpropcrry to perform necd;4;~ ~
Signature Contractor's License No. Date
Permit Valuation
Permit Fee S
Plan Check Fee S
State Surcharge S
Penalty S
Plumbing Permit Fee S
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
TlUs Application Becomes Your Buildinl Pennit When Approved
Buildin2 Official
Date
Park Support Fee ## $
SAC ## $
Water Meter SizeS/S"; I"; S
Pressure Reducer $
Sewer/Water Connection Fee ## $
Water Tower Fee ## $
Builder's Deposit $
Other $
TOTAL DUE $ /}~? -
I ~~:e i~o -::- ~
I ~,ptNo~J J
ThIS IS to cerrify that the request in the above application and accompanying documents is in accordance with !be City Zoning Ordinance and may proceed as requL'StL-d. This document
when signed by the City Planner constItutes a temporary Certilicate of Zoning compliance and aUows conslI'UClion to commence. Before occupancy. a Cl'lliflCate of Occupancy must be
issued
Planning Director
Date Special Conditions. if any
24 hour notice for all inspections (9!\2) 447-98~, fn (9~2) 447-424~
16200 Eagle Creek Avenue Prior Lake, MN 55372