HomeMy WebLinkAboutBuilding 06-0660
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7 2- ?I-~ 0.6,
I White
Pink
Yellow
File
City
Applicant
[ PERMIT NO. Oft,. 0&(,0 I
( Please
ADDRESS
ZONING (office use)
1- lis-
CflbIJ/VuT
~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2..:S ze&. (I~'Z...~ 0
OWNER
(Name)
5 hc,...('" () v-.
('l\~d' l.' "-
(Phone)
(Address)
,--
i BUILDER r./\.
I (Company Name) ,r l{...:f,...O
I (Contact Name) 8h...-rT
(Address) ..J
~O~ ~p"c""""Lfzts -!f\c...
(Phone) q ~~- ct:1 Lf- r:; t; () 1
(Phone)
TYPE OF WORK 0 New Construction ODeck
OAddition OAlteration
.Siding OLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Mise.
I
E
II
F
I
III
H
2
IV
I
3
V
M
4
A
R
5
B
S U
PROJECT COST IV AI...UE
(excluding land)
$
I hereby certitY that I have f\.lf0l511.>d mformation on this application which is to the best of my knowledge true and correct. I {llso certify that I am the owner or authorIzed agent for the
,lbove.mentHlned property a I tha' all construction will conform to allexlstmg statc and local laws and will procced m accordance with submltted plans I am aware that the buildmg
otflcial can r' lke tlm perml .nr JU cause Furthermore, I hereby agree that the CIty offIcial or a deSIgnee may enter upon the property to perform needed mspcctHlns
dO~(, rn7"J
Contractor's License No,
J la'-llo"
Date
Water Tower Fee
#
#
$
$
$
$
$
$
I $
$
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
I $
$
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
: Plumbing Permit Fee
!Mechamcal Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Builder's Deposit
Other
Buildlllg Ullielal
Date
TOT AI... DUE
..cJV
This Application Becomes Your Building Permit When Approved
I Thls IS to certify th,)t the requl'st In the above applicatIOn and accompanymg documents is m accordance with the City Zoning Ordinance and may procecd as requested. TIllS document
I v./hen signed by the City Planner constItutes a temporary Certificate of ZOllmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
IISSIICd
L
Planning Direetor
Speeial Conditions. if any
Date
24 hour notice for all inspections (952) -1-17.9850, fax (952) -1-17--12-15
16200 Eagle Creek Avenue Prior Lake, MN 55372