HomeMy WebLinkAboutBuilding 06-1117
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
Date Rec' d
1 White
Pink
Yellow
I PERMIT NO. 0(,. -///71
File
City
Applicant
ZONING (office use)
L!IJf;5
15 ({ r~1 s i-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
ct C-C{A~-
s- Iia
V't.A.4,/fAC
L'D <?~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address) I Lj
PID;?':)- ~_~3<D-" Olq-()
lLu S)' eb CtCu.......
(Phone)
rf<;'2 ~Y7 - ~,yy 7
.
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(Phone) 7 h 3 - 4 r 7 - ~ b 3 7
(Phone) 76? - 2 '3 ~ - ~ 7 30
(h~
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing lKlRe-Siding OLower Level FinIsh 0 Fireplilce
OAddltIOn OAlteration o Utility COnnectIon "\
CODE: DI.R.C. DI.B.c. o Mise.
Type of Constmction: 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: I 2 3 4 5
I hereby (cnity that I have furnished Information on this application which 1S to the best of my knowledge true and correct. I also certify that I am the owner or authOrIzed agent for the
<Ibl lYc-mcntIoned propcrty and that illl Clll1structlOn will conform to all existIng state and local laws .1nd will proceed in accordance with submItted plans_ I am aware that the buildIng
orticial can revoke thiS pcrmil!(1!' Just cause Furthermore, I hereby agree that the City official or a deSIgnee may enter upon the propel1y to perl(1I'm needed mspecl10ns
x_D tUt6~ z~S'-Y2S-8'b
Signature
Permit Valuation
Contractor's License No,
_-1 2. - Z 7 - ok,
Dilte
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Illllldlllg Ufflclal
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # $
Builder's Deposit i $
Other $
TOTAL DUE $ '7~ --
'4- _---
Paid ' t <Q-
Date/:::) . ~'7 ~ 0 lo
Receipt No, \~;J. ') ~ ;;l-.I
By !)-_____ .
ThIS IS to certify that the request In the abl)Ve applicatlOI1 and accompanYll1g documents is III accordance with the City Zoning Ordinance and may pn>cel'd as requested ThiS document
v..'hl'n signed hy the City Pl.1nncr constItutes a temporary Certificate of Zonlllg compliance and aUov,'s cunstruction to commence. Before occupancy, a Certificate l)f Occupancy must be
issued
Planning Direclor
Special Conditions, if any
Date
24 hour notier for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372