HomeMy WebLinkAboutBuilding 06-0935
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
X'1~ ~/'#~
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
Date Rec' d
10./6.ofo
I White
Pink
Yellow
I PERMIT NO.
O';t'f~sl
,
File
City
Applicant
ZONING (office use)
5E
PID 21: 180. 063. 0
(Phone)
,-
i BUILDER .,.., A J
I (Company Name) W 6"5/ tA J( I ~
I (Contact Name) C/~J
(Address) ? c:> 0 - I V-f. /
(Phone)
(Phone)
?~-:J'" f'l/' 030 If
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
o Mise
B
S
U
PROJECT COST /V ALUE $
(excluding land)
x
I hereby certify that I have furmshed mformatlon on this applicatIOn which IS to the hest of my knowledge true and ClJlTee!. I also certify that I am the owner or authOrized agent I(lr the
above-mentIOned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submltted plans. I am aware that the buildmg
llftiClal can revoke tlm permIt flll lust cause Furthe .more, I y agree that t ' CIty official or a deSIgnee may enter upon the property to perform needed mspcctHlns
/oh,./t>6
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
This Application Becomes Your Building Permit When Approved
HuiJdll1g UrIlclal
Date
Contractor's License No. Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $
ThIS IS to certify that the request m the abuve applIcatlOn and accompanY1Og ducufficnts 15 10 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner cnnstItutcs a temporary Certificate of ZOl1mg compliance and allllws CllOstruction to commence Before occupancy, a Certificate nf Occupancy must be
i."iSlIcd
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