HomeMy WebLinkAboutBLDG 07-0121
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
Y CERTIFICATE OF ZONING COMPLIANCE
UTILITY CONNECTION PERMIT
2)5
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
.3.13,D7
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Pink
Yellow
I PERMIT NO.
07,0(2/
File
City
Applicant
ZONING (office use)
4-.0
OWNE~
(Name) ~(2...
M~7
(Phone) (p I 'L "7") o-<tt 4/ '-I.
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction OOeck OPorch
OAddillon o Alterallon OUtility Con
ORe-Siding OLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.C. o Mise ._.._----~
Type of Constnlction: I II III IV V A B PROJECT COST /V ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furmshed Informatllln on thIs applicatlllO which IS to the best of my knowledge true and correct I also certify that I am the owner or authorized agent t"r the
above-mcnl1oned property and that all construction Will CLlnf"rm to all eXistIng state and local laws and will proceed In accordance with submitted plans I am aware that the buildIng
official call revoke this permIt for Just cause Furthermore, I hereby agree that the Clty offIcial or a desIgnee may enter upon the propel1y to perform needed mspcctHms
X 3/'3/(')~--
Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
! Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
This Application Becomes Your Building Permit When Approved
=J
Date
Ilulldtllg Urtleial
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 $ 7~-
ThiS 1S to certify that the request 1I1 the above applicatlOll and accnmpanYll1g documents is In accordance with the City Zoning Ordinance and may pn)(,cl'd ilS requested ThiS dllCumcnt
when signed by the CIty Planner constItutes a temporary Certltlcate of ZonIng comphance and allows constructInn to commence Before llccupancy, a Certificate llf Occupancy must be
isslled
Planning Director
Special Conditions. if any
Date
24 hOl1r notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372