HomeMy WebLinkAboutBuilding 07-0923
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
?, ~7/o1
File
City
Applicant
I PERMIT NO. 0 -', 0943 I
] White
Pink
Yellow
ADDRESS
/c;.833
~ti~A/ t5
C4 te..- .
ZONING (office lIse)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
~0-J. ~
ILl Y33
(Address)
UOvlvt'~ C~lll
-pc nh{ 0 V:
(Phone)
qs J-4'-17- fej3 d-
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration OUtility Conn tl
CODE: OLR.C. OLB.C.
Type of Constmction:
Occupancy Group: A B
Division:
o Mise.
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby ccrtify that I have hlrnrshcd infOrmatIOn on this application which IS to the best of my kno\vlcdge true and COtTect. I also certIfy that I am the owner or authorIzcd agent for the
Jbllve-mentlllned prDperty and tbat all CllnstructlDn wIll cDnfrJrm tll allexlstrng state and lllcallaws and will proceed rn accordance witb submItted plans. I am aware tbat the buildrng
llfflclal can revDke s permIt teJr Just cause Fur 'ImOle, I heleby agree that the CIty Dffleral or a deSIgnee may enter upDn the plOpet1y tll pertOlm needed II1spectlllns
'- 0 / /, , ---.,
X r " lu -C1 lid- 7 I{) I
Contractor's LIcense No Date
Permit Valuation
Permit Fee
Park Support Fee
SAC
#
#
$
$
$
$
$
$
I $
$
TOTAL DUE
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace PermIt Fee
This Application Becomes Your Building Permit When Approved
. 1
Iluildlng Unicial
Date
$
$
$
$
$
$
$
$
$
ThIS IS to elTtlfy that the request in the above application and accompanYll1g documents IS in accordance with the City Zoning Ordinance and may pn)ccL'i..1 as requested TillS document
when signed by the City Planner constItutes a temporary Certificate of Zomng compliance and allows nmstructton to commence. Before occupancy, a Certificate of Occupancy must be
i.sslIcd
Planning Director
Special Condilions, if any