HomeMy WebLinkAboutBuilding 06-0736
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/5')&0
..r "
Date Rec' d
8~/.s.~~
1 White
Pink
J Yel1C)\\l
I PERMIT NO. O~. () 13{4 1
,
File
City
Applicant
ZONING (office use)
f1 t &.r
~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2..5: 031'. 02-2...0
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name) Bel\JS~N J:Sh'c.-"'- ~~~+O,.J< ~..UL.. (Phone)
(Contact Name) t:=r ,'~ ~c....w.1oN. (Phone)
(Address)
Lk.
10
~-~-~~
J~
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
DAddition DAlteration DUtility ConnectIon
Re-Siding OLower Level Finish 0 Fireplace
411 t,T. S7D/f16
CODE: DI.R.C. DI.B.c. o Misc.
Type of Constmction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I herl'by certify that I have hlrnished 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
above-mentlOned property and that all construction WIll conform to all eXlstmg state and local laws and WIll proceed in aCCllrdance with submItted plans I am aware that the buildmg
(,nil'ial can revoke tillS permit for Just cause Furthermore, 1 hereby agree that the CIty official or a deSignee may enter upon the property to perfilI'm needed mspectmns
x
Signature
Contractor's License No.
Date
Permit Valuation
()
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
BuiJdlllg Ot'ticlal
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water ConnectlOn Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ '7~ 00
,
No. SZZZ(,
ThIS IS to ('{'[tit)' that the request in the above applicatlon and accompanYlIlg documents is In accordance with the City Zoning Ordinance and may proceed as requested TillS dncumcnt
when signed by the City Planner constItutes a temporary Certificate of Zonmg complIance and allows construction to commence Before occupancy, a Certificate of Occupancy must be
Isslled
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