HomeMy WebLinkAboutBuilding 07-0151
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 3(2.- 2---( D 7
I PERMIT NO.O 7-{jl 5{
I White
Pink
Yellow
File
City
Applicant
rl 0f4 ~ T I...L.- $.€2
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
PIDZr-. z..-q4- .014-. 0
(Phone)
(Address)
BUILDER
(Company Name) c..oG' ~e:;a...J,CJC:S
(Contact Name) ~
(Address) 511,CI ~S
(Phone) 9.5"2.. 2. '''2.....l- -I ~
(Phone)
~~
TYPE OF WORK 0 New Construction ODeck OPorch lM'Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddItIon OAlteration DUtility Connectl~
CODE: ~I.R.C. OI.B.C..
Type of ~struction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
o Mise
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$ ~ 00c:>
I hereby certity that I have hlrmshed rnl""rmatHln on this applicalion which IS to the best of my knowledge true and correct. I also certify that I am the owner III authorIzed agent f"r the
Jbovc-m twned pll1perty and that all constructlllI1 will eonfmm to all eXlstrng state and local laws and will proceed in acemdance with submItted plans I ,1m aware that the blllldrng
official can 1 ke thiS permit for Just cause Furthermore, I hereby agree that the City official or a deSignee may enter upon the propeny to perform needed inspections
x
Signature
Permit Valuation
Permit Fee
Plan Check Fee
-
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
, ,
$
$
$
I $
$
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
'-~
I~'
Buildlllg UfIiclal
s/z ~ It) 7
I Date
Zd12- 0'" -+~
Contractor's License No.
__3/~_bl
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit I $
Other $
TOTAL DUE $ 7tn.oo
Paid t( fj I., '0 0
Date 31-u...{. 7
Receipt No. 53 Z.,7
By ~
ThiS IS to certify that the request In the ,lbove application and accompanymg documents IS 111 accordance with the City Zoning Ordinance and may proceed as requested. ThiS dllCumcnt
\vhcn signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence Before llccupancy, a Certtficatc llfOccupancy must be
lsstled
Planning Director
Special Condilions, if any
Date
24 hour notice for all inspections (952) ~47-9850, fax (952) ~~7-~2~5
4646 Dakota Street Prior Lake, MN 55372