HomeMy WebLinkAboutBuilding 06-0905
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF WNING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
IL/OS":s
GY't' enwa.-y .Avre 4
1Jb377-
I PERMIT NO. O~ 05" I
I ZONINGc__1 I
I, White Fil"
2. Pi.. City
) Yellow AppIica..
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
(Address)
/CAy (!~'-() r
o 63 ::7V't'" t3rI W
(phone) ~'Y2::) i(t(J~ 5'11 7
OWNER
(Name)
A-ve .
BUlLDEll
(Company Nam
(Contact Name]
(Address)
THO At-Home Services, Inc.
DBA The Home Depot Home Services
3200 Cobb Galleria Pkwy., #200
Atlanta, GA 30339 (763) 542-8826
LICENSE: #20268257
(phone)
(Phone)
TYPE OF WORK. 0 New Construction ODedc OPorch QlIRe-Rooling DRe-Siding OLower Level Fimsh 0 Fireplace
OAddition OAlteration OUtility Connection 0 Mise,
CODE: OI.R.C. OI.B.C.
Type of Constnu:tion: I
Occupaacy Group: A B E
Diyision:
n
F
1
m IV V A B
HI MRSU
2 3 4 5
PROJECT COSTIV ALUE
(excluding land)
s /~. q 1 7
,
I hereby certify lhat I have fumisMd information on this application whid1 is to the best of my know~ true and correct, I also certify that I am the owner ur authonzcd a&a1t for the
above-menuoned property and that auction will conform to aU existina slate and local laws and will proceed in accordance with submitted plans. I am awate that the buildina
:fficiaI /~I just ' Furthamorc, I hereby agree thai the city official or a drsiJnee may enler upon the property 10 pcrfonn needed ';7; ~j,
Signature Contractor's Ucense No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size S/8"; I"; S
State Surcharge S Pressure Reducer S
Penalty S SewerlWater Connection Fee # S
Plumbing Permit Fee S Water Tower Fee # S
Mechanical Permit Fee $ Builder's Deposit S
Sewer & Water Permit Fee S Other $ A
Gas Fireplace Permit Fee $ TOTAL DUE I s '1&--
- I .
This Application B<<omes Your BuiltIina Pmnit When Approye' Paid III ' I R~ ~int No. ~7~J I
Date 70.11 .11& I Bv - I
Buildinll. Official Date (
TIus IS to certify lhallhe request in the above application and accompanyina documents is in accordance with tile City Zooin. Ordinance and may proceed as requL'StCd, This documenl
when siJned by the City Planner constitutcs a temporuy Certificate of Zonin. compliance and allows construction to commenc:e, Before occupancy. a Certificate of Occupancy must be
issued
PIannins DinlctDr Date Soecial Conditions. if IDY
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