HomeMy WebLinkAboutBuilding 06-0412
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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. 00 - ~/4-
File
City
Applicant
LEGAL DESCRIPTION (office use only) ~ n
LOT ~LOCK I ADDITION fXQJ2
~'1:~R /Jor?~/4 /tIt-
(Address)
ZONING (office use)
'" ti/ ;< IUd-
PID,;?~-' -3 ~;;)- (J3c; 6
(Phone)
?-5.J - 'fr 7-Lj(S r
BUILDER / J
(Company Name) 5o/c.-v- /1n/,^,,~r>C
(Contact Name) %, ~ i <~S j-.A..:t....
(Address)
~L
u"'-c........
(Phone)
(Phone)
76.!.'~s7 S70:L
76'S:'.5 7!J-,;.t'o3
ORe-Siding OLower Level FinIsh
o Fireplace
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility Connection
clcJ.eJ-
("f)DE: DI.R.C. DI.B.c. o Misc.
, of Construction: I II III IV V A B
.1pancy Group: A B E F H I M R S U
Vivision: I 2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have furnIshed mtiJrmatlOn on this applicatIOn which is to the best of my knowledge true and correct. I also certify that I am the owner or autho1'lzed agent for the
above-mentIOned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can revoke tlllS permit for Just cause Furthermore, I hereby agree that the City official or a designee may enter upon the propelty to perform needed mspectlons.
X "'~ L---- ~ -;2 J . tJb
" 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 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 $ I~ .e-,. '1
/.?d~b; b
5- 8 -
I ~;ceiPt N~/LI4.1
Paid
Date
.s to certify that the request in the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. TIllS document
wilen signed by the City Planner Cllnstltutes a temporary Certificate of ZOnIng compliance and allows constructIOn to commence. Before occupancy, a Certltlcate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspectious (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
TYPE OF WORK SO l4Y ~ <
USE OF BUILDING r H
PERMIT NO. 0'- LlI ~ . DJ\TE ISSUED s. ~~* "
BUILDER ~OTdL~ m rCl tV~fb"'" PHONE #7' '3- 55'}~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I F___ "h~ I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I T- ---,~ I I
I FINAL I W(? I L)' 74 '~
FOR ALL INSPECTIONS (952) 447-9850