HomeMy WebLinkAboutBuilding 06-0923
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Please
ADDRESS
tp5~~ ~dr~V- f I
tJ . t:.. (')
lr,'
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER j)
(Name) ---K(~"
(Address)
Date Rec' d
Whi,e
Pink
Yellow
I PERMIT NOOb-
9a~
File
City
Applicanl
ZONING (office use)
PID.
(Phone) 1oI.;) - q /p 3. - q ~ J.4
BUILDER
(Company Name)
(Contact Name)
(Address)
IflO..I.r ......... LLC
P.o....
......1.IMt lei 5P12
(Phone) qSJ. .-'~- \<jG'1
(Phone)
TYPE OF WORK 0 New Construction ODeck DPorch 't2ke-Roofing ORe-Siding DLower Level Fimsh 0 Fireplace
DAddition DAlteration DUtility Conn&~ 0 Misc.
CODE: OI.R.C. OI.D.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
ill IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST /V ALUE S
(excluding land)
10,1.)00
x
I htTeby cenify that I have furnished information on this application which is to the best of my knowledge true and correct. I also cenify that I am the owner or authonzcd agent for the
above-mentioned propeny and that aU construction WIll conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
offici n revoke this it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the propeny to perform needed lOspcctions.
~
Pennit Valuation c:A6 C){)-
Permit Fee $ ?
-?t./ 7~
Plan Check Fee $ I~ 95
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
Buildin!! Ollicinl
Dnle
d..()y-o.,;;) \ ~4-
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 $ /~.-
I Paid
Date
~~
/~ -{~
I ~iP'N;i:r:d6
thIS IS to cmify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the City Planner constitutes a temporary Cenificate of Zoning compliance and allows construction to commence Before occupancy, a Cenificatc of Occupancy must be
issued
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372