HomeMy WebLinkAboutBuilding Permit 09-0092
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White File
Pink City
Yellow Applicant
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIA
AND UTILITY CONNECTION PERMIT
ZONING (office use)
/703 0
PfI15",q Sfl/\/T /"1 f37;DO vV
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck DPorch
DAddition DAlteration DUtility Conn
e-Siding DLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.C. o Mise,
Type of Construction: I II III IV V A B PROJECT COST IV 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 furnished mformatIon on this applicatIon which is to the best of my knowledge true and correct. I also certify that I am the owner or authOrize,! agent for the
above-mentIOned property and that all construction will con for all existmg state and local laws and will proceed in accordance with submItted plans I am aware that the buildmg
official can revoke thiS permit for Just cause urther 'C, I eby agree that the CIty official or a deSignee may enter upon the property to perform needed mspectlons.
Signa
x
Contractor's License No.
Date
Sewer & Water Permit Fee
Water Tower Fee
Builder's Deposit
Other
#
#
$
$
$
$
$
$
$
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
Plan Check Fee
Sewer/Water Connection Fee
BUlldln!! Otlieial
Date
This Application Becomes Your Building Permit When Approved
ThIS IS to certify that the request III the above applicatIOn and accompanymg documents IS m accordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the Cay Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certlticate of Occupancy must be
isslIed
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372