HomeMy WebLinkAboutBuilding 06-0841
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
'I. /). O(P
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. ~~. 0'#
ZONING (office use)
St!/8'1
;;,~~
/r
5~
4-,~r' { ~k--
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
TYPE OF WORK 0 New Construction ODeck o Porch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
(Phone)
OWllffiR Ai . J/
(Name) /I/{I5o
(Address) C;-~t.(
BUILDER
(Company Name)
(Contact Name)
(Address) Z <8{,
Lt~ (Phone) 7',.. Z-Z?:Z-tI!'/"? I
(Phone)
(
/1111.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Mise.
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S
U
PROJECT COST /V ALUE $
(excluding land)
I hereby certify that I have furnished mformation on this application which is III the best of my knowledge true and correct. I also certIfy that I am the owner or authOrized agent for the
above-mentIllned property and that all construction will conform to all eXisting state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official ca rev ke th s ermll fo l t cause Irthermore, I hereby agree that the City official or a deSignee may enter upon the propelty to perform needed inspectIOns
9-/s--06
x
"U:Jsv/t'58
Contractor's License No.
Date
Water Tower Fee
#
$
$
$
$
$
$
$
$
$
---
Permit Valuation
Permit Fee $ 7~-
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
$
Park Support Fee
SAC
#
#
Water Meter SizeS/S"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
Builder's Deposit
Other
TOTAL DUE
Paid
Date
'/('116.
I I
I ReCeitt No. ~ 2'-fO{,
By ?IJ
ThlS IS to certify that the requcst in the above applicatIon and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner constItutes a temporary Certificate of Zoning compltance and allows construction to commence. Before occupancy, a Cerlltlcate "fOccupaney must be
isslIed
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any