HomeMy WebLinkAboutBuilding 08-0540
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' dJ
7 zyur
(Please
ADDRESS
( y r J..5
+-l'dd~
(/ I l-W
White
Pink
3 Yellow
File
City
Applicant
PERMIT NO. Of;. {bttfO
ZONING (office use)
LEGAL DESCRlPTION (office use only)
LOT
ADDITION
PID
BLOCK
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
tv~r'''e-G-;' U,,>I-.
8ry (;e- (2A "" -rh oJ,..
q7tJ
.c...
(Phone)
(Phone)
(;'5"1) ;)..oq- 3/7(')
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddltion OAlteration OUtility Connec 0
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
III
H
2
IV V
I M
3 4
A
R
5
I
E
II
F
I
o Misc.
B
S
U
PROJECT COST /V ALUE
(excluding land)
$
I hereby certifY that I have rurnlshed Information 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-mentIOned property and that all CDnstruetion 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 propelty to perform needed inspections
~~;?
---
x
Signature
-"7hfl ~,
. . Date
Contractor's License No.
Park Support Fee
#
#
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
Buildillt! Otlicial
Date
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
.7 ~----
ThiS IS to eertlfY that the request In the above application and accompanYing documents IS In accordance with the City Zllning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner CllnstItutes a temporary Certificate of Zoning compliance and allows CllnstruCtlon to Cllmmence Before llceupancy, a CertIficate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notiee for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372