HomeMy WebLinkAboutBuilding 07-0866
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE. .
AND UTILITY CONNECTION PERMIT
2_1~tLj
Date Rec' d
I. While File I PERMIT NO 8
2. Pink City . 07. 0 (p(p
J Yellow Applic:a.. .
I {I40 /11 y . 1- b j,.. 111.,1 SF
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
OWNER !vi"~ k~V11' kv !tv; II
(Name) d-
(Address)
PID
I ZONlNGc__J
(phone) 4 Sl-l{L/7 - 5j g (J
BUJLDER
(Company Name)
(Contact Name)
(Address) 5&tf/
(phone) uGI'~~9. t': 3M
.
(phone)
/ :5-StJ 8' aL
TYPE OF WORK D.New Construction DDedc Dporch !5lRe.R.oofing DRe-5idiDg OLower Level Finish 0 Fireplace
DAddition DAlteration OUtility Connection 0 Misc.
. CODE: OJ.R.C. OJ.B.C.
Type of CODStnIction: J
Occupancy Group: A B E
Division:
n mIVVAB
F HI MRSU
I 2 3 4 5
PR.OJECT COST /V ALUE $
(excluding land)
,:>', l!/JO-
I Mreby certify that I have furnished information on this applic:atlon which is to the: best of my knOWledge aue and COI1'I!Cl. I also certify that I am the Uwnl'l' or authorized agent for the:
above.lIlI!tIboned property and that all construction will conform to aIlexistina sta~ and local laws and will proem! in accordance with submiued pians. I am aware lhat the buildin,
:lciaJ can m'Oke this P:t for just i!} :;:crmore. I hereby aan:e that the city ~; ; ;;.~ ;- enter upon the property to pcrfurm needed W;/O 7
Signature Contractor's License No. Dare
Permit VaIuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Pennit Fee
Gas Fireplace Permit Fee
Park Support Fee
SAC
#
#
$
S
$
S
S
S
S
S
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
#
#
This Application Becomes Your Buildinl Permit When Apprond
Buildin Official
Date
$
S
S
S
S
S
S
S
S
nlls is to certify thaI the request in the above application and ilCCompanyins documents is in accordance with the City looin, Ordinance and may proceed as reqUl.'Stl:d. This document
whe:n si,ncd by the City Planner constitutes a temporiU)/ Cmillcate of looinS compliance and aUows consauction to comllll!llce. BcfOl'l! oc:c:upancy, a Cl'l'tirlClltc of Occupancy must be
issued
Planning Director
Date
24 hour notice for all Inspections (~1) 447-98!tO, fIX (~1) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372