HomeMy WebLinkAboutBuilding 06-0822
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
at bottom)
Date Rec' d
] White
Pink
Yellow
File
City
Applicant
PERMIT NO. CJC -
s> d--~
ZONING (office use)
/L/3
U Cz-U~IJ (L
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Phone) iSz - 3"39- 17,-,
OWNER,. . . .
(Name) '~~IO ."'^ \<I\~
(Address)
PIDd5- ;=3~9--C9,S--Q
BUILDER ^ '. ,
(Company Name) L,.....~(".,;ODb ~O^"S~VC\lOf'J (
(Contact Name) ~ !\i<..Nbv l~
I G L-- '8 k. '\t.C ~'T,
(Address)
(Phone) i~L - f9(--'f,( 2s' '-/
(Phone) b(2 - <:(sl, - [,2-03
oJc.~
5HAkc.~eE
K"'-'
TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing
OAddition OAlteration o Utility ConnectIon
ORe-Siding OLower Level Finish 0 Fireplace
pJJ SIal / ll//J/d CJtU / 1l..'cC}a fY1- E>
PROJECT COST IV ALUE $ ~7 02' ?~
(excluding land)
CODE: OI.R.C. OI.B.C. o Misc.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
I hereby certity Ihat I have hlrnished mformation on this applicatIOn which IS to the best of my knowledge true and cOITect. I also certify that I am the owner or authollzed agent for the
above-mcnlIoned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submllted plans. I am aware that the buildmg
official can f.s.. s per t for st cause Furthermore, I hereby agree that the Clty official or a designee may enter upon the propelty to perform needed InSpectIOns
L
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Y OUT Building Permit When Approved
BuildllH! Onicial
Date
9 - 7 -0 G
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 $ '-1115
~'~.-
(~ ~?0
Paid
Date
I ~;c'iPt NOf. 8' ol)
ThiS IS to certIfy that the request in the above applicalIon and accompanymg documents IS in accordance with the City Zoning Ordinance and may proceed as requested. TIllS document
when signed by the CIty Planner constItutes a temporalY Certificate of Zonmg compliance and allows constructIOn to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hOllr notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372