HomeMy WebLinkAboutBuilding 06-0440
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec 1 d
S-7C"Ob
(Please
ADDRESS
I White
Pink
Yellow
I PERMIT NO. Or; . () ~
File
City
Applicant
ZONING (office use)
4-92&
/2c/7Z- 6-VGb Sf
Sb
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
PID e.s
09/. C> 2-1.
01
I
(Phone)
(Address)
(Phone) 6 / ~ ~~ I () ~ b~0c7
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Conn tIOn
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
III
H
2
IV
I
3
V
M
4
A
R
5
I
E
II
F
I
o Mise
B
S
v
PROJECT COST/VALVE $
(excluding land)
I hereby certify that 1 have hlrnlshed Information 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 te)r the
above-mentIOned properry and that all construction will conform to all eXIstIng state and local laws and will proceed in accordance with submitted plans I am aware that the buildIng
:f1C1al can revoke thIS perml~ ca~ . J rmore, I hereby agree that the Clry official or a designee may enter upon the propeJ1y to perform nee~/n.-..ec~))s 'c;,Jb
Signarure Contractor's License No. D te
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
I
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
BuildUH! Ofticial
Date
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 $
ThIS IS to certifY that the request in the above applIcatIOn and accompanYIng documents is In accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner constllutes a temporary Certificate of ZonIng complIance and allows construction to commence. Before occupancy, a Certlticate 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