HomeMy WebLinkAboutBuilding 06-0865
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CITY OF PRIOR LAKE RUILDINC llEUMIl,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
n at bottom)
Date Itec
9. 2,5.0(,
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 0(,. 0 ~(, 5' I
1
~.E
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
PID z..r: z.bG,. ~ Z. f. 0
(Phone)
(Address)
i BUILDER L 1
I (Company Name)C i?/16,1J. S IO,,;Vf- '\f"~ -,t':JU;4L
I (Contact Name) J'~. "?/J'rt 1'L111/(f'Jv
(Address) 1 t46:. C-
l ~(Phone) tr.i.. -3.1 r - 233 ~
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
OAddition OAlteration o Utility ConnectIOn
CODE: OLR.C. OLB.C.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
o Misc.
B
S
U
PROJECT COST /V ALUE
(excluding land)
$ ) 0 'b6
I hereby certify that I have turnts cd mfnrmatio!1 on this application which IS to the best of my knowledge true and conect I also certify that I am the owner or authOrIzed agent for the
Jat all c tructlOn will Cllnfl)rm to all eXlstmg state and loeallaws and will proceed in accordance with submItted plans I a aware that the buildmg
.thcrmore, I herehy agree that the CIty official or it deSIgnee may enter upon the propeI1y to perform needed inS (tlOIlS
8:!~icense No ~~ 1> S-
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 $ I
This Application Becomes Your Building Permit When Approved
Ilulldlllg Ofliclal
Dale
Park Support Fee
SAC
#
#
$
$
$
$
$
$
.dd
5'2.-/'1-.
ThiS IS to certify that the request 111 the abuve application and accompanYlIlg documents is 111 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed hy the City Planner constitutes a temporalY Certifi.cate uf ZOllll1g compliance and allows construction to commence Before occupancy, it CertIficate of Occupancy must be
issued
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
-
,.() ("
Planning Direelor
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Speeial Conditions, if any