HomeMy WebLinkAboutBuilding 06-0762
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
n at bottom)
/1Vt$('/FlO~N/9 tf~
ADDRESS
/(, ,5~
Date Rec' d
8.2/.0(,
White
Pink
Yellow
I PERMIT NO. OCP. 0 7h zt
File
City
Applicant
ZONING (office use)
ute-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID z..s: ~ 95", 001. ()
OWNER
(Name) 1-19}.J Fo A 0
L _ ;9Dtlt/l
(Phone)
1'S--; tf4-7 0J-- / Z
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration OUtility ConnectIon
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
III
H
2
IV
I
3
V
M
4
A
R
5
I
E
II
F
I
o Misc.
B
S
$
PROJECT COST IV ALUE
(excluding land)
U
I hereby certify that I have hlrmshed lOformatlOn on this applical10n which IS to the best of my knowledge true and correct. I alsD certIfy that I am the Dwner or authDnzed agent fln the
abovc-menl1oned property and that all construction WIll conform to all exisl1ng state and local laws and will proceed in accordance with submItted plans. I am aware that the buildlOg
DtTiclal can revoke this permIt for) t cause Furthermore, I h e agree that the City official or a designee may enter upon the property to perform needed rnspectllln.
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
Date
8uildlll!! Otticlal
Contractor's License No.
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
ThIS IS tD certify that the request in the above applieal10n and accompanyrng documents IS lo accordance With the City Zoning Ordinance and may proceed as requested ThIS dDcuffient
when signed by the City Planner consl1lutl'S a temporary Certificate of ZOning compliance and allows construction to commence. Before occupancy, a Certificate of Occupaney must 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