HomeMy WebLinkAboutBuilding 06-0025
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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
I PERMIT NO.O&.Uoz:5I
File
City
Applicant
ZONING (office lIse)
322/
L.-/) K--G ..t? (,(j r;:- dA /Z~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
PID ?K..3 71. (J 2<,7. (j
(Phone)
(Address)
(Phone)
(Phone)
(, 5"'{- 4 ~ '7 - yO? 3
", vol s- ~ c)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration o Utility Connection
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV
I
3
V
M
4
e-Siding OLower Level Finish 0 Fireplace
o Mise.
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I have furmshed mformation on this applicatIOn which IS to the best of my knowledge true and correct. I also cerlify that I am the owner or authollze,j agent for the
Jbove-mentloned propelty and thJt all construction will conform to Jll eXlstmg state and local laws and wIll proceed in accordance with submItted plans. I am aware that the buildrng
offIcial can rev'.)~~.:!~~Zause ,~ore. I hereby agree that the CIty official or a designee may enter upon the propelty to perform needed rnspeclions
X / . /"'*,/ A ~ /- {....-e:; <-
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee i $
Sewer & Water Permit Fee i $
Gas Fireplace Permtl Fee $
This Application Becomes Your Building Permit When Approved
BlIlldll1!! Unicial
Dale
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 $ 7fb. PV
~~...t;t
1~;Pt No
5lJg .g-.
Paid
Date
ThIS IS to certIfy that the request in the abuve applicatlun and accompanymg documents IS m accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner cunstltutes a temporary Certificate of Zonmg compliance and allows cunstructIOn to commence Before uccllpancy, 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