HomeMy WebLinkAboutBuilding 06-0433
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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5311 /2~)ttl;J50/v UtC-
I White
Pink
Yellow
File
City
Applicant
PERMIT NO. O~. 04-.33
ZONING (office use)
,e/
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
PID 2-..),-- ,B-X ()(H:'~. 0
(Phone)
(Address)
I' BUILDER J1jl ~ r I:
(Company Name) DOl -. f}7 fh I ~
(Contact Name) , I ~L
(Address) . -/ 0 tk S>~
(01\ S.
(p l.l-~~tj- )w"7 4-
(Phone)
(Phone)
~-
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration o Utility Conn
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
III
H
2
V
M
4
A
R
5
IV
I
3
I
E
II
F
1
'"
ORe-Siding OLower Level Finish 0 Fireplace
o Misc.
B
S U
PROJECT COST /V ALUE
(excluding land)
$
I hereby certify that I have hlrnished 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 for the
above-mentioned property 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
official can revo e th,s permit for Just cau e Furthermore, I hereby agree that the City official or a designee may enter upon the property to perform needed inspections
X' (.~- A 1//1-- ')- 2)--Ofo
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
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
BlIildll1~ Ollielal
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 $
C,q-u
.s-, z".J rei '"
ThIS IS to certify that the request In the above applicalion and accompanymg documents IS in accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner conslitutes a temporaty Certificate of Zoning compliance and allows construCllon to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspeetions (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372