HomeMy WebLinkAboutBuilding 06-0812
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CITY OF PRIOR LAKE BUILDING PERMIT.
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please e or rint and si n at bottom)
ADDRESS
/6'6 00 U//I/it{} t:~ f
Date Uec
I White
Pink
Yellow
I PERMIT NO. Db - og/"2...1
File
City
Applicant
ZONING (office use)
uJ
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
) tit ~- e/ r.r-
Ihh'~ w/
~ 7b~-;;)Jt.,,-~
,(.)
7
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ~e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration o Utility Conne~n
CODE: ~I.R.C. DI.B.c.
Type of &nstmction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V
HIM
234
o Misc.
A
R
5
4)"t!JO.oo
B
S
U
PROJECT COST IV ALUE $
(excluding land)
hich IS to the best of my knowledge true and correct. I also certIfy that I am the owner or authonzed agent for the
I eXIstIng state and local laws and will proceed in accordance with submItted plans. I am aware that the buildIng
ec that the CIty offiCIal or a deSIgnee may enter upon the propcny to perform needed InspectIOns
Permit Valuation ~5'"(50, 0-0
Permit Fee $ 7'1. 7 S-
Plan Check Fee $ -
State Surcharge $ I'LS
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildmg Ofticial
~/.s-/() "
; Date
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 $ 7' . () f:J
(.j~t::
I ~ce~~z 2 7f?
Paid
Date
ThIS IS to certifY that the requt'st in the above applicatIon and accompanymg documents is In accordance with the City loning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constItutes a tcmporalY Certificate of Zomng compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy mllst be
issued
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