HomeMy WebLinkAboutBuilding 06-0444
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
Yellow
I PERMIT NO. ()h-4L/~
File
City
Applicant
ZONING (office use)
T{'ot;
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
fube( t
XU" J \(~
(Phone)
'-I '-I, -L-j<A K'
(Address)
BUILDER l/
(Company Name) 'f'\ ( {0S{ (
(Contact Name) _tJ\\ \....;z
~o-h'~
8-00 ~ s+-
(Phone)
(Phone)
() y-c{ CA. n
(Address)
3<:050
w
~c
qSJ-L{qd--3~Lf~
q~;}..L(f;} -4'1 (f
TYPE OF WORK 0 New Construction ODeck OPorch !)aRe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
IV
I
3
V
M
4
A
R
5
II
F
I
III
H
2
I
E
o Mise
B
S
PROJECT COST IV ALUE $
(excluding land)
u
I hereby certify that I have hlrDlshed mformatlon on this applicatIOn which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent Illl the
above-mentIOned property and that all construction will conform to all eXlstmg state and local laws and will proceed in accordance with submltted plans. I am aware that the buildmg
official can revoke thiS permit for Just cause urthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propel1y to perform needed mspectlons
X XCA,~ dol d 3115 :S/3/ loc"
Signature Contractor's License No. Date
Permit Valuation ~StJl)--
Permit Fee $ '7t/- 7~
Plan Check Fee $ 1;J.5
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
BuildllH! Omelal
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 $ '7tb, --
3/ '-/ r13
Paid
Date
~~/30~ b
I ~~'g:o
ThiS IS to certify that the request m the above applical10n and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner constitutes a temporary Certificate of Zomng compliance and allows construCl1on 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