HomeMy WebLinkAboutBuilding 06-0368
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
ADDRESS
5511
LEGAL DESCRIPTION (office use only)
LOT (BLOCK ADDITION
OWNER
(N ame)
~.., ~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
Date Rec'd
5 5. Ow
White
Pink
Yellow
I PERMIT NO. 0/:;-- "3to ~ I
File
City
Applicant
~.
ZONING (office use)
Lo-
PID
5"03
(Phone/l 5 ;).. '-f 51~ 7/ b ~
(Phone)
(Phone)
b r;{-'7 95 '-/- J-b l.f k
~61 - '] flLf.... (lro, t{ J,
TYPE OF WORK D New Construction DDeck DPorch ~e-Roofing ~e-Siding DLower Level Finish D Fireplace
DAddition DAlteration DUtiJity ConnecIo-~ D Misc.
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST/VALUE $ {<?J <0'13" 00
(excluding lan~~~~ 1'. oD
x
I hereby certify that I have fi.Jrmshed mformation on this application which is to the best of my knowledge true and correct. I also certIfy that I am the owner or authOrIzed agent for the
above-menlloned property and that all construction Will conform to all exisllng state and local laws and will proceed in accordance with submItted plans I am aware that the buildmg
official can coke this perml J1I6t cal e Flllthelm re, I heleby agree that the City offiCial or a deSIgnee may enter upon the property to perform needed mspectlons
dt-l7 tt '6 5 ~1J ~tJ ~
Contractor's LIcense No Date
Permit Valuation ,;(50eJ_ .-
Permit Fee $ ~t/.IS
Plan Check Fee $ / ",-JS-
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
l3uildlllu Otlicial
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ '7G..-
Paid
Date
;~~~ :;-
G:.
I ~~JNO -6 NtlJ---'1
ThIS IS to certify that the request m the above applicatIon and accompanying documents is m accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constltutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy 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