HomeMy WebLinkAboutBuilding 06-0408
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/jIJA471 <5: t- I
d!oAWX!d ~ ;)rd;~r- oO\()-o/(~O
) /jij/-
LEGAL DESCRIPTION (office use only)
LOT I / BLOCK
ADDITION
OWNER
(Name)
H &14/1-1 f-I~ SA VVl S
')73Q - 574 I tf IA rz~N
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 0/0- L/~
ZONING (office use)
(Address)
57
Sf-
(Phone)
PrL { 0 1Z--
lJIZ~2-02-Zv4-s;
LA K'-~, /L4JJ 553=;,?
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
DAddition
e-Siding DLower Level Finish o Fireplace
o Misc. wJfl1C1 tJa.E
I II III IV V A B PROJECT COST IV ALUE $
E F H I M R S U
I 2 3 4 5 (excluding land)
TYPE OF WORK
'-'0DE: DI.R.C. DI.B.c.
e of Construction:
~l1pancy Group: A B
Division:
I hereby e ify th I have furnished lIlformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorIzed agent for the
above- entl ned roperty and that a l construction will conform to all eXisting state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
"fIlcial -an re 0 _, s p mlt fll! JU 'ause FlllthclmOle, I heleby aglee that the City ofllClal or a deSignee may enter upon the propelty to pel form necdcd mspcctH) s
~A1/L / S; . 3
Ignature "l 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 I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildltlg Otlicial
Date
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 $ f}f.o -~
Uaid
Date
i u,' -~
. /. d3-G
I Re"iW 0 ,&j- { /.j fJ'~
By L.
.' IS 10 certify Ihat the request in the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as rcquestcd This document
when signed by the City Planner constItutes a temporary Certificate of Zonmg comphance and allows construction to commence. Beforc occupancy, a Certlf,catc of Occupancy must be
issued
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