HomeMy WebLinkAboutBuilding 06-0033
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
oG
/12,
1 White
Pink
_1 Yellow
File
City
Applicant
I PERMIT NO.OC? 0033 I
1,A. _
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID GJ- I G 1. () 6 L ()
OWNER
(Name)
Jv1 t'-kt,-e [ ( H V1.-5 Y1,' t,
0"(q(9 WAlk (Jr,
(Phone
9~::)} CJ1L(-'> 180
-
(Address)
f"/I,C9/'- L a./re
/\/[/v
S .5"""1';;>,
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction
DAdditlOn DAlteration
e-Siding DLower Level Fimsh 0 Fireplace
CODE: OLR.C. OLB.C. o Misc.
Type of Constnlction: I II III IV V A B PROJECT COST /V ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certily that I have hlrnishcd mfmmal10n on this application which is to the best of my knowledge true and correct. I also certify that I am the owner m authonze,l agent for the
above-mentIoned property and that all construction will conform to all eXlstmg state and local laws and will proceed m accordance with submitted plans I am aware that the buildmg
:""' ~~' "'" ",n'''mo".' '''''' '." "" ",,'" "~~4-?'4' ";;;''';'00 "" ~"p"W 10 po flOm "''{''d ;"~""; (;
Signature Contractor's License No. Date
Gas Fireplace Permit Fee
$
$
$
$
$
$
I $
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
$
$
$
$
$
$
$
$
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
~ J'1J1J (,
Park Support Fee
SAC
#
#
Builder's Deposit
Other
This Application Becomes Your Building Permit When Approved
{,{~}
TOTAL DUE
BlllldllH! OfIicial
Date
This IS to certify that the request lt1 the above applicatlon and accompanymg documents is In accordance with the City Zoning Ordinance od may proceed as requested. ThIs document
when signed by the City Planner conStltutes a temporary Certificate of ZOIlmg compliance and allows construction to commence Before occupancy, a Ccrtltkatc of Occupancy must be
isslIed
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any