HomeMy WebLinkAboutBuilding 06-0815
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
3 [SlY
I White
Pink
Yellow
File
City
Applicant
\ PERMIT NO. O~ -- ~/_S- \
ZONING (offIce use)
P J2<<J~'1';Y/
o
L1 -Ii (/
/
(})e!r'~~
PID ,;2j- - 0'1 [/- O;;;Zqk
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
~rt
.
ifill J
(Phone)
l.j~() - ~ 3:J. :3
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ORe-Siding OLower Level Finish
o Fireplace
o New Construction ODeck OPorch tz'Re-Roofing
OAddition OAlteration OUtility Connec~n
o Misc.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group:
Division:
A
B
I hereby certily that I have furmshed mformation on this application which is to the best of my knowledge true and correct. I also cerllly that I am the owner or authorized agent for the
ahove-menlloned property and that all construction Will conform to all eXlStlng state and local laws and will proceed m accordance with submitted plans. I am aware that the buildmg
':"" '" '"'' . ",mmb [m '{!"" ',,"h,rm"'", 1 hm,by ,"'" "" ", "" "",,i,'"" dmig'" =Y "'''' "'00 ", ,,",my m ",,[mm ""d,' 7,/Z ~,
Signa Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
I
E
II
F
I
III IV
H I
2 3
V
M
4
A
R
5
This Application Becomes Your Building Pennit When Approved
BuildllH! Ot1icial
Date
B
S U
PROJECT COST IV ALUE $
(excluding land)
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 $ 7C. .~
I~~ce~/ g (.~
~ Paid
Date
/& q-: - to
ThIS IS to cerllfy that the request 10 the abuve applicallon and accompanying documents IS 10 accordance WIth the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and anows construcllon to commence. Before occupancy, a Certlticatc of Occupancy must be
isslIed
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372