HomeMy WebLinkAboutBUILDING 08-0133
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1/I/tJgI
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 08 - tJ / $3
ZONING (office use)
3~\
\
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER 1'2.. .
(N ame ) l...)I\ Q...T'
(Address) 3()to \
<D C+\ EFt E'U)
+\ ~ vJ~ ~t }) E:;E, '12- \:) .
(Phone)
I' BUILDER N I I
(Company Name) EN \..J\ 'f-["
I (Contact Name) D",~
(Address) 2... ~7~ I LL w<Xill
~c.,T\~6
(Phone) (o'S\-3S3-Co 1\ ~
(Phone) ~'5\-6S3-(o,Jj
V\AJ4{>L~6cU J/'4 tJ I 'SSll ~
L,
TYPE OF WORK 0 New Construction ODeck o Porch ~e-Roofing
OAddltlon OAlteration o Utility Conne&lO~
~e-Siding OLower Level Finish
~ILT'~(,.)
o Fireplace
CODE: ~.R.C. OLB.C. o Misc.
Type of onstruction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: (3 2 3 4 5
PROJECT COST IV ALUE
(excluding land)
$ ~ 5" J ooe
I hereby certify that I h~ve hlrmshed mfmmatHlO on tIllS apphc~tlon which IS to the best of my knowledge true ~nd correct. I ~1so certify th~t I am Ihe owner m authOrIzed ~gent tllr the
II constructiun will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans I am aware that the building
cause II her e, I hereby agree that the CIty off'2.0;:~e9~~~lO the propeny to perf()rm n~e/n/'e7)o <r:,
Signature Contractor's License No. I Date
x
Permit Valuation
$
1,2-
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 $ 7" .t) 0
Permit Fee
Plan Check Fee
State Surcharge
~~~ $
Plumbing Permit Fee $
Mechal11cal Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permtt Fee $
11Uildlllg Ortlclal
'//0r
dt~
I paid'~t'.OO
Date J , I (J ~
Receipt No. 'S~Sq 2...
~.
This Application Becomes Your Building Permit When Approved
~~
By
ThiS IS to certify that the request In the above applicatlOn and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed hy the City Planner constitutes a temporary Certificate of Zonmg compliance and allows nmstruction to commence Before occupancy, a Certificate of Occupancy mllst be
issued
Planning Director
Special Conditions, if any
Date
2~ hour noticr for all insprrtions (952) ~~7-985(). fax (952) ~~7-~2~5
4646 Dakota Street Prior Lake, MN 55372