HomeMy WebLinkAboutBuilding 06-0732
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
Date Rec' d
I White
Pink
Yellow
File
City
Applicant
PERMIT NO.c9~ - 732.
Sw
ZONING (office use)
PID 2
-07.,7--0
OWNE~ \ " "-
(Name) Ct --t '(' \ '- \ ~
(Address)
S OW r:r J
(Phone)
q)L-+fo~~0h
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ~e-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration o Utility Connection
CODE: ~.R.C. OI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
o Misc
A
R
5
B
S
PROJECT COST IV ALUE
(excluding land)
$
U
I hereby certify that I have hlrmshed mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
"bove-mentlOned propnty and that all constructIOn w1l1 conform to all eXIStmg state and local laws and will proceed m accordance with submItted plans I am aware that the buildmg
ottiClal revok' tillS permIt I()r Just c se Furthermore, I hereby agree that the City offiCial or a deSignee may enter upon the property to perform needed mspectlOns.
x
Signature
Permit Valuation 2St)O. --
Permit Fee $ "1i\.1'\
Plan Check Fee $
State Surcharge $ !.2-5
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
Contractor's License No.
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water ConnectIOn Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ I~.-
Jf'k
f-~
,
Receipt No. ,q- '2. 2 'L. ,
By gJ)l~
r Paid
Date
This IS to certitY that the request in the above applicatIon and accumpanYlng documents is 1O accordance with the City Zoning Ordinance and may proceed as requested TillS doclImer
when signed by the City Planner cnnstItutcs a temporary Certificate of ZonlOg compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must'
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