HomeMy WebLinkAboutBuilding 06-1048
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE. .
AND UTILITY CONNECTION PERMIT
~~M;.. .w;:
I ADDRESS
\/~{ Rl eL Cow*-
Date Rec' d
//,UJ.ob
I. Whil. File
2. Pink City
) Yellow Appli....
I PERMIT NO. (p . /OH;
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) =p~
(Address) t
iM-t
I ZONlNGc__, I
PID ~~ z.q
. l>
(phone) c:,:;;;. - Ql{6-r;)O 9
(phone) 3~O'-) l/o'-{.~.r5
(Phone)
'.~03
TYPE OF WORK 0 New Construction ODeck o Porch e-Roofing DRe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connectio 0 Misc.
CODE: OI.R.C. OI.B.C.
Type of Construction: I
Ocmpancy Group: A B E
Division:
n
F
1
ill IV V A B
HIM R S U
2 3 4 5
s 755l/'l)'
PROJECT COST IV ALUE
(excluding land)
I hereby certify that I have furnished information on this application which is to the best of my Icnowlc. b1Ie and COtTeCt. I also certify that I am the owner or authonZl'd ilCnt for the
above-mentIoned propeny and that aU consb1lction will conform to aU existing state and 10callaws and will proceed in accordancc with submitted plans. I am aware that the building
omci~permil for ju~t cause. Furthermore. I hereby ape that the CIty official or a designee ma~ ~ter upon the propeny to perform needed mspcctions. ,~
X ~t, ~d.bt;6Llq --1, ,-(5-06'
Signature Contractor's License No. Dall:
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge S
Penalty $
Plumbing Permit Fee S
Mechanical Permit Fee S
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee S
This Application Becomes Your Building Permit When Approve'
Buildin2 Official
Dale
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer S
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit S
Other $
TOTAL DUE $ 7r, -
if No. 5Zr;r;f!
I Paid
Date
f;' -
_ z.,O .-0 (,
ThIS IS to certify that the request in the above application and accompanying documents is in acconlance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporuy Certificate of Zoning compliance and allows constnJClion to commence. Before occupancy, a Cl'ttificate of Occupancy must be
issued
Pbuminll Director
Date Special Conditioas, if my
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4145
16200 Eagle Creek Avenue Prior Lake, MN 55372
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