HomeMy WebLinkAboutBuilding 05-0554
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
Date Rec' d
I White
Pink
Yellow
File
City
.\pplicant
[PERMIT NO. 05 - 7 '2l L(
ZONING (office use)
(o,S 56
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TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roo1i.ng ~e-Siding
OAddition o Alteration OUtility ConnectIOn I '\
o Mise
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20'LD\~~
Contractor's License No.
LEGAL DESCRIPTION (offtce use only)
LOT BLOCK -;tADDlTION
OWNE~
(Name)
(Address)
(Address)
CODE: OI.R.C. OI.B.C.
Type of Constnlction:
Occupancy Group:
LDivision:
I
E
II
F
I
III IV
H I
2 3
V
M
4
A
R
5
A
B
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
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,y
PlD It( J.. -cCf1
J
(Phone)
1
L
OLower Level Finish
o Fireplace
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B
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PROJECT COST IV ALUE $
(excluding land)
;:} lC;VV
-=
Park Support Fee
SAC
# $
# $
$
$
# $
# $
$
$
$ I
~
i R'C~ lf~ 1<6'') \
\ By _~ ]
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOT AL DUE
F1':~, c.?- (,,1 .;~ ~S
Build1l1!!. OffiCIal
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issued
Date
J
Planning Director
Special Conditions, if any
Dat~
24 honr notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372