HomeMy WebLinkAboutBuilding 06-0310
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
Date Rec' d
1- 2" ~ () h
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO.C?C" 03 10
TJLt.- J t1/
ZONING (office use)
38/4- Cl/c,CC7J /~GHrf
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 25" 0 9'~ oo+: ~)
OWNER
(Name)
,~ ~ r: (
-
..Jet-I.---
G- fl.€. EN
I Oc U{/J &c..,~1 t~.IQ.~ 501t (Phone) (1)~) 440 -IvO i tv
. '75' .-r-z
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Con
I~)
./
(Phone) ;JSZ .-i({Z,- '2 7Zg
(Phone)
eel/It G/Z-Cj7)-77'1?
O~
e-Roofing
ctIon
ORe-Siding
o Fireplace
OLower Level Finish
CODE: OLR.C. OLB.C. o Mise.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
x
I hereby certity that I have hlfnlshed Information on this application which is to the best of my knowledge true and COlTect. I also certifY that I am the owner or authof!zed agent for the
Jbove-mentlOned property and that all wnstruction wIll conform to all eXIsting state and local laws and will proceed in accordance with submitted plans, I am aware that the building
,,!f1cial can rev s perI1llt fo cause Furthermore, I hereby agree that the City official or a deSIgnee may enter upon the property to perform needed InSpectlllns,
" tfr?,-) -0 ~
Date
Signature
Permit Valuation 2 [IFZr. L ('
Permit Fee $ ,
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permtt Fee $
This Application Becomes Your Building Permit When Approved
Buildlll!! Ofticial
Date
Contractor's License No,
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 ll1 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner constItutes a temporary Certiticate of Zoning 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 inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372