HomeMy WebLinkAboutBuilding 06-0699
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
.s 3//
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
\/err
-
(Address)
Date Rec' d
1 White
Pink
3 Yellow
File
City
Applicant
I PERMIT NO. 06- 6 71'
o/k.;--.
(Phone)
BUILDER
(Company Name)
(Contact Name)
(Address)
i,{/~ ~ /j1a~+e }--~{)
PO {30)( (9.63'1/
r/Y) 15 ,35ij eM
(Phone)
(Phone)
ZONING (office use)
PID
-6
.OCJ
~/()...
7? / -a 3 '-5-
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connectio
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
III
H
2
PROJECT COST /V ALUE
(excluding land)
$
IV
I
3
V
M
4
A
R
5
B
S U
II
F
I
I have hlr ed informatIOn on this application which IS to the best of my knowledge true and conecl. I also certily that I am the owner Dr authonzed agent for the
and th all construction will conform to all eXlsung state and local laws and will proceed in accordance with submitted plans I am aware that the building
. pe It for JU cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the propelty to perform needed inspectIOns
. ~/d--6
Contractor's License No. Date
x
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
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
~r-;-~
This Application Becomes Your Building Pennit When Approved
BuildllH! Official
Paid
Date
Date
#
#
$
$
$
$
$
$
$
$
$ 11";-
#
#
I Recei::.
BYU
TIllS IS to clTtlfy that the request 111 the abuve application and accompanYing documents is 111 accordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the City Planner constitutes a temporary Certificate of Zoning complIance and allows construction to commence. Before occupancy, a Certltlcatl' 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