HomeMy WebLinkAboutBuilding 06-0776
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I'J.. W 1'/ low
Beo..c-''n ~ ~I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
Oe,^-\\ --r; Wt1:', enJ
35/~ w,//()W e'....(Jh -r;.~/ /
(Address)
BUILDER
(Company Name)
(Contact Name) rr2, nt). e s~'\.o...
Date Rec' d
1 White
Pink
3 Yellow
File
City
Applicant
7?fo
I PERMIT NO. ~- 'r~
ZONING (office use)
PID
~-Iot- {t?d-Q
(Phone) '1,,^-830~~Oa)'
(Phone)
(Phone) ,e. 3 - 3'll - s.~o 8
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ~Re-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility ConnectlOn
CODE: OI.R.C. OI.B.C. o Mise
Type of Construction: I II III IV V A B {4J {). 40 00
Occupancy Group: A B E F H I M R S U PROJECT COST IV ALUE $
Division: I 2 3 4 5 (excluding land)
I hereby certify that 1 have h,rnlshed mformatlon on this application which is to the best of my knowledge true and correct I alsLl certify that I am the owner or authorized agent ttlr the
above-mentIOned property and that all construction will conform to all extstrng state and local laws and will proceed in accordance with submitted plans I am aware that the blllldrng
ot1icial can revoke thIS per urthermore, I hereby agree that the City official or a deSignee may enter upon the propeny to perform needed rnspectHlns
?II~/(){;,
bate
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 Your Building Permit When Approved
l3uildmg Ofticial
Date
;z ~77
Contractor's License No ;J. 'it 17
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 $ 1(0,--
'7~,.;~ -0 I~N0/~('G-'
Paid
Date
ThIS IS to certify that the request III the abllve applicatIon and accompanYlllg documents IS III accordance wIth the City Zllning Ordinance and may proceed as requested. Tim document
when signed by the City Planner CllnstItutes a temporary Certificate of Zonmg complrance and allllws CllnstrUctlon to commence. Before llccupancy, a Certltieate of Occupancy must be
I 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