HomeMy WebLinkAboutBuilding 06-0306
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1- Z1-: c>b
File
City
Applicant
PERMIT NO. ()G.~ (;i 30 k;;
I White
Pink
Yellow
'/ tJ;lS'
~ rc7A1rtJ
LEGAL DESCRIPTION (office use only)
ZONING (office use)
LO
BLOCK
ADDITION
PID 2- ':). Z[O. (I C7 . ()
OWNER
(Name)
(Address)
, ('Ip\.ft?~
HJ <:-
(Phone)
15;1- '117-- /tl-.S7
c" ,
~'r~t
BUILDER
(Company Name)
(Contact Name) & <,Nd-
(Address)
95~ - 91.s - 7;;;1;; ~
, l' nC'f'l"7I"JQ H~
. :,:~;,~ I~:' . ~. r~..MOnl=L1NG.I~one)
_ 'I,,) i:XCf:LSIOR BLVD
':i' i '-)i 11' iJA,AK M . (Phone)
'.- ~':"' " 1 N 55416
It) #1}0010S0
TYPE OF WORK 0 New Construction ODeck OPorch }GRe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration OUtility Connection D Mise.
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
III IV V A
HIM R
2 3 4 5
B
S V
PROJECT COST/VALVE $
(excluding land)
I
E
II
F
1
~,5"c10
I hereby cerrity that I have hlrmshed mformation on this applicatIon which is 1'0 the best of my knowledge true and COlTec!. I also cerl1ty rhat I am the owner or authonzed agent for the
above-menl1oned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can revoke thIs permit for u cause u\ther re, I hereby agree that the CIty official or a designee may enter upon the properry to perform needed mspecl1 ns
x
/ t?-St:J
Contractor's License No.
Signature
Permit Valuation
Permit Fee
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
Plan Check Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Gas Fireplace Permit Fee
This Application Becomes Your Building Pennit When Approved
Buildll1!! OlliciaJ
Date
$
$
$
$
$
$
$
$
$
~;YZ_c.
ThiS IS to certity that the request m the above applicatIOn and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested Thts document
when signed by the City Planner conSl1tutes a temporary Certificate of Zomng compliance and allows construcrion to commence. Before occupancy, a Cerl1llcate 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