HomeMy WebLinkAboutBldg Permit 08-667 Repairs
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
8, Z(p. 08
~i~~e ~:~y I PERMIT NO, g.,t -~ 1
Yellow Applicant ~
at bottom)
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
(Address)
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(Phone) 3S""';l'-2ol -Sf:";l ')
~=R 5- I ~ "'- CW
,.BUILDER 0
(Company Name) /rL ~ -+.e.- t-l~ t).e..v.e(o~~ "'- t
(Contact Name) _:JJ tf K L A~ h. At- /
(Address) S- '-1.~..e.-r;;04. L4 ~S ~('~. t;"J...elt
[. ""- (0_ (Phone) :J S;; -,2!1 r - ~<r-3l.t
(Phone) <J S- ,).- ~ 01 , - <-t It 1:2:-
p,;.f~ rl e.... . V
TYPE OF WORK 0 New Construction DDeck DPorch DRe-Rzofing j2R-Siding DLower Level Finish
DAddition DAlteration DUtility Connection
CODE: ~I.R.C. DI.B.c. Misc. G--PA1 (L
Type of Constnlction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
I hereby certifY that I have fhmished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or alllhonzed agent for the
above-menuoned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke this permit for Just cause. Furthermore, I hereby agree that the City official or a designee may enter upon the property to perform needed mspections.
x. "5n ='~, \.. ) 3. O(~g:J.. ~ 7 :J ~
\ Signature Contractor's License No. ate
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; I"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
$ TOTAL DUE $ ,.
Paid 1l~~ Receipt No. ~~t;~
Date By
ThiS IS to certifY 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 Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate 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
4646 Dakota Street Prior Lake, MN 55372
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