HomeMy WebLinkAboutBuilding 06-0787
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
1--/ 2. 2..
Wt-OteltDo
LEGAL DESCRIPTION (office use only)
Date Rec' d
8. 2.5. 0(,
I White
Pink
Yellow
I PERMIT NO. (}(,. /) 7 a 71
File
City
Applicant
GT J!e15T
ZONING (office use)
,€/so
LOT
BLOCK.3 ADDITION L/1,e:GfliJe G~e:AIs
PID 25. oo{,. 03Z. J
OWNER
(Name)
'3-(.. t{. tIV\
-
ctJ I d ItkV I)
(Address)
~1'1
L/1'-2
(Phone) '1)). - 'IY7- ('3 '(i'
$(-
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding DLower L~v~ish 0 Fireplace
OAddition OAlteration OUtility Conn ction
CODE: DI.R.C. DI.B.c. o Misc.
Type of Constmction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certify that 1 have hlrnished mformatlon on this application whIch is to the best of my knowledge true and COllect. I also certify that I am the owner or authOrized agent for the
ahove-me property a all construction wiIl conform to all eXlstmg state and local laws and WlIl proceed in accordance with submllted plans Ita awar~' th the buildrng
"fflClal n revoK tlm per t fo' st cause Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the prOpeJ1y to perform need~~e ~n~ 1.110
X
Signature
Permit Valuation Z~ SOO. 00
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 Your Building Permit When Approved
Blttldl11~ OfIicial
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(,. 00
ThIS IS to certify that the request in the above applicatIOn and accompany 109 documents is 10 accordance with the City Zoning Ordrnance and may proceed as requested. Tim document
when signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before nccupancy, a CertIficate of Occupancy must be
issued
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