HomeMy WebLinkAboutBuilding 06-0790
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I. White File
2 Pink City
J YeJlow AppliCllnl
Date Rec' d
12-Yjo (p
I PERMIT NO. 0" -t>7't 0 I
I
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I~~~:~o;>t: ~Ai/ ~E
/
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
ZONING (office use)
--
J6t+tV <;r;AI
- ~; / St?
(Phone)
OWNE~
(Name) (Y\O+~ -:g~OKS
(Address) '5 n
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction o Deck OPorch lJ)e-Roofing ORe.Siding OLower Level Fimsh 0 Fireplace
OAddition DAlteration OUtility Connection 0 Misc.
CODE: IXlI.R.C. OI.B.C.
Type of ~~ction:
Occupancy Group: A B
Division:
IT
F
1
ill IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE S
(excluding land)
I
E
I ht'feby certify that I have furnished information on this application which is to the best of my Icnowledge true and correct. I also certify that J am the owner or authonzed agent for the
above-menl1oned property and that all construction will conform to all existing state and local laws and will proceed in accordance with mbmilled plans. I am aware that the building
official can revoke this permit for just cause. Furthermo~~he City official or a designee may enter upon the property to perform ne~;Z;tld ~
Contractor's License No. Date
Permit Valuation Fr~S'OO, 00
Permit Fee $ T7'{. 7 S-
Plan Check Fee $ -
State Surcharge $ l. Z5
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pmnit When Approved
~,~ rt/z;:.(O Co
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".00
I Paid ~.o 0
Date 3$/Dlo
I ~~iPI ~u..o
ThIs IS to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requl'Sted. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (9~2) 447-98~, fax (9~2) 447-424~
16200 Eagle Creek Avenue Prior Lake, MN 55372