HomeMy WebLinkAboutBuilding 07-0478
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
~ . /..3 . 07
n at bottom)
] White
Pink
Yellow
File
City
Applicant
(Please
ADDRESS
L.J 5D
PERMIT NO. () 7. 047tJ
-ilzi Y
ZONING (office use)
12d-..
-fJ ~:'f---(
UN/! ~7
LEGAL DESCRIPTION (office use only)
W,{LJl,1d;eK7 ADDITION {M { {~Ul! (Ul{lia? Q~ I/I:i) -PID ,J):6;)7 -i/n-c,
OWNER
(Name)
,4alf.- 1~~/1
Lf3D7 . ?1/'Yl1/17/t'{ ,5'~2:~f-
(Phone)
1/'1- 7 ~ c7/ ( Ci
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
Iec.--Vj IJ 10/11 /J ~ 11./ JI7t. .
7. L-
(Phone)
(Phone)
& I Z - 77 o. 94--9 7
TYPE OF WORK 0 New Construction
OAddition OAltera on
ck OPorch ORe-Roofing
o Utility Connection
ORe-Siding
OLower Level Finish
o Fireplace
CODE: ~LR.C. OLB.C.
Type of &nstmction:
Occupancy Group: A B
Division:
o Mise.
I
E
II
F
I
III IV V
HIM
2 3 4
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
B Dff) <,....-
I hereby certlty that j have turmshedlOf()rmatmn on thiS applIcatIOn WhICh IS to the hesl of my knowledge Irue and cOlTect. I also certify Illat I am the owner or authOrized agent hJr the
ahove-men mned property and at all constructllln Will cont(Jrm to alll'xIStmg state and local laws and will proceed in accordance with suhmItted plans I am aware that the hutldlOg
offieia! ca revoke tI1lS permIt fo )11. cause Furthermore, I hereby agree that the City official or a deSignee may enter upon the propeny to pert(ltm needed lOspectlllllS
;} C)sg :See C, ~
Contractor's License No.
Co - I ~ r-G-')
Date
x
Permit Valuation
Park Support Fee
SAC
#
#
$
$
$
$
$
$
I $
$
Permit Fee
Plan Check Fee
Water Meter Size 5/8"; I",
Pressure Reducer
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
$
$
$
I $
$
Sewer/Water Connection Fec
#
#
Water Tower Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
~
~
t;//L/lo7
Date
TOTAL DUE
This Application Becomes Y OUT Building Permit When Approved
BUlldll1u Ufticlal
ThIS IS 10 ClTtlfy that the request ll1 the above application and accompanYll1g documents IS ll1 accordance WIth the City Zoning Ordmance and may proceed as requested. TIllS document
when signed hy the CIty Planner constItutes a temporary Certificate of Zomng compliance and allows constructll)IJ to commence. Before occupancy, a Certificate of Occupancy musl he
lSSllCd
Planning Director
Special Conditions, if any
Date
24 hour uoticc for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
TYPE OF WORK
USE OF BUILDING
PERMIT NO. . .
BUILDER 'IJ PHONE # ~/z.. no. "'"
NOTE: THIS IS NOT A PE IT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
rr
INSPECTOR DATE
, FOOTING ( 4) I ~ . I fA r {{ 10 7 ,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~i~ - ~ ~CJc BoAjJs h~: :
I F1t'-1AL I VVl.. (n / Kef)
FOR ALL INSPEC.TIONS (952) 447-9850