HomeMy WebLinkAboutBuilding 06-0370
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I White
Pink
Yellow
File
City
Applicant
[ PERMIT NO. (!) (p- 3 '1 ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOTI () BLOCK d- ADDITION
PID ~5-
80-()/ -0
OWNER
(Name)
D ^ ~ 'j tA ..J- ~e "'le.
L..uJ rett C L
(Phone) 15 J... '-ILf7- 36~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
.l. n-rr r fa Ice (\
'15;;2- qOl -1?t8(
h' ;).- 3rfl- 7/ }if
TYPE OF WORK 0 New Construction DDeck DPorch (}(Re-Roofing ~e-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Conne~~ r'c
CODE: DI.R.C. DI.B.C.
Type of Constmction:
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 ALUE
(excluding land)
$ dS,cru
I hcreby certify that I have hlrmshed mfllrmatlon on this application which IS to the best of my knowledge true and correct. I also certIfy that I am the owner llr authonzed agent fllr the
abnve-mentlOned property and that all constn tion will conform to all eXIsting state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
official can revoke t permit~r Just cause urthermorc, I hereby agree that the City official or a deSignee may enter upon the propeny to perform needed mspectlons.
;)051;). 739 5 / it / (1)6
Contractor's License No. J Date
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Park Support Fee
SAC
x
Builder's Deposit
Other
# $
# $
$
$
# $
# $
$
$
$ ~,--
I ~;CC}: 5 N ,;J es
Permit Valuation
Permit Fee
Plan Check Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Gas Fireplace Permit Fee
TOTAL DUE
I Paid )~Co'i-
Da(t)..... ()-
This Application Becomes Your Building Permit When Approved
BuildltH! Umcial
Date
ThiS IS 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
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all iuspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372