HomeMy WebLinkAboutBuilding 06-0848
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
t(1'ltJrb
I While
Pink
Yellow
File
City
Aprlicant
I PERMITNO.O{,. oB~ I
(Please n at bottom)
ADDRESS
/4-3/ e /U/r Cf 6,leJ
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z5"
o
()'~ 0
OWNER
(Name)
(Phone)
(Address)
i BUILDER
I~ Name)lICtllrt;CT(/~ At )/(lUti' X!.6 {/A//<.CE f
(Contact Name) /CK /VE"t-v" T.ft?/v'
(Address) StJ7 :::ee/V' W
(Phone) b/ L ,')CJO ~ 2./1 /
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition DAlteration DUtility Con
e-Roofing
tlOn
ORe-Siding
OLower Level Finish
o Fireplace
CODE: DI.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
I
III
H
2
IV
I
3
V
M
4
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certity that I have htrmshed mformatIon on this application which IS to the best of my knowledge true and correct. I also certIfy that I am the owner or authof\zed agent for the
abnve.mentlllned property and tho t all constructIon will conform to all eXlstmg statc and local laws and will procced in accordance with submIlled plans I am aware that thc bUlldmg
official can revoke tillS per - s cause roinYcrmorc, I heleby agree that the Clty official ur a deslgnee may enteI' upon the ptopeJ1y to peJform needed InSpectIons
.~ 9/lc;/ot
Contractor's License No Date
x
This Application Becomes Your Building Permit When Approved
Paid
Date
~ '/;;"
# $
# $
$
$
# $
# $
$
$
$ .PlJ
IttNo
Gas Fireplace Permit Fee
$
$
$
$
$
$
I $
$
Park Support Fee
SAC
Permit Valuation
Permit Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Plan Check Fee
Sewer/Water Connectton Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
nuildll1!! OffIcial
Date
TIllS IS to certIfy that the request 10 the abnve applicallon and acctlmpanymg dtlcuments IS 10 accordance with the City loning Ordinance and may proceed as requested. ThIS dncumenl
when signed by the City Planner constItutes a temporal)' Certificate of Zonll1g compliance and allows constructIon to commence Before occupancy, a CertIficate of Occupancy must be
isslled
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372