HomeMy WebLinkAboutBuilding 06-1053
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
3 i /'0
/VI ""L--O W W co 0
Date Rec' d
II. 2../. 0 {;,
] White
Pink
Yellow
File
City
Applicant
I PERMIT NO. (p. /053
Sf.
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID zs- z-,r. Of&'. ()
OWNER
(Name) :Dan
(Address)
t\~~
820 wi' O\.U\..OO
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone) ~'5~- '-1'-/,- S/~ J
(Phone)
(Phone)
TYPE OF WORK 0 New Construction OOeck OPorch
OAddition OAlteration OUtility Conn
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III
H
2
IV V
1 M
3 4
A
R
5
ORe-Siding OLower Level FinIsh 0 Fireplace
o Mise
B
S
U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have hlrOlshed mformation on thIs apphcat1lJn which IS to the best of my knowledge true and colTect. I also certIfy that I am the owner or authonzed agent for the
above-mentlOned property and that all construction Will conform to all eXlstmg state and local laws and will proceed in accordance with submltted plans I am aware that the buildmg
ofllela! can revoke tillS permIt for Just cause Furthermore,! hereby agree that the city official or a deSignee may enter upon the propclty to perform needed 10s )ectmn,
.
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee I $
Sewer & Water Permit Fee i $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildtng Unicial
Date
Contractor's License No,
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 10 the above application and accompanYlllg documents is 10 accordance with the City Zoning Ordinance and may proceed as requested, TIllS document
when signed by the City Planner constItutes a temporary Certificate of Zonrng compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
i.'islIl'd
Planning Direetor
Special Conditions. if any
Date
24 hour noticc for all inspcctions (952) .t47-91l50, fax (952) 447-.t245
4646 Dakota Street Prior Lake, MN 55372