HomeMy WebLinkAboutBldg Permit 09-0145, 09-0465
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
4-. IS; 0;
File
City
Applicant
I PERMIT NO. 09,014-51
While
Pink
Yellow
(Please
ADDRESS
g IZf3, E-=t;
PT.
je.CJ
153/1
LEGAL DES<;RIPTION (office use only)
/4-~ IS
LOT BLOCK ADDITION
3/l(;;c~
PT
ZONING (office use)
OWNER
(Name)
(Phone)
PID
(Address)
BUILDER . I
(Company Name) :) Toll<.o 6PcfiJ) U ".>L,. Co tJS1'Mtt!-110N: I rJc,
(Contact Name) tN1Ll~ U/Ji-liZ.,L
.~ (.1) 1
(Phone) (;SI--+21O-0055
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility ConnectIOn
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Mise
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I avc furnIShed mfllrmatlon on this applicatIOn which IS to the best of my knowledge true and correct. I also certIfy that I am the owner or authonzed agent for the
above-mentwned pr erty and that all constructton WIll conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
~liCiaI ca~ ke t s permIt for justcause Furthermore. I hereby agree that the CIty official ~~Y1n~ upon the propelty to perform needed msp~~;;;'t
Signature Contractor's License No. Date
Permi
Park Support Fee
SAC
Permit Fee
$
$
$
$
$
$
$
$
TOTAL DUE
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
Buildlll!! Otliclal
Date
#
#
$
$
$
$
$
$
$
$
$ 7(,.00
#
#
ThIS IS to certify that the request in the above applicatIon and accompanymg documents IS in accordance with the City Zoning Ordinance and may proceed as requested. Thts document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction 11l commence. Before occupancy, a Certificate of Occupancy must be
issued
Special Conditions, if any
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
Date Rec' d
White File
Pink City
YeHow Applicant
~?'f
ZONING (office use)
is~tl
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name) /~ ~VbL\,,*-
(Contact Name) ~ (~lf-rJ
(Address)
~~{
(Phone) ~( - 'VZC(- CJ5l1
(Phone)
TYPE OF WORK 0 New constm; ODeck OPorch ORe-Roofing
OAddition (~teration OUtility ConnectIOn
CODE: DI.R.C. DI.B.c. 0 Mise.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
ORe-Siding OLower Level FinIsh
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
x
I hereby certify that I have n.lrmshed mformatlOn on this application which is to the best of my knowledge true and correct. I also certtfy that I am the llwner or authllltZed agent for the
above-mentIOned propcrty and that all onstruction WIll conform to all eXlsttng state and local laws and will proceed in accordance with submttted plans. I am aware that the buildmg
official can revoke thIS It ~ r Just auSe Furthermore. I hereby agree that the CIty official or a deSIgnee may enter upon the property to perform needed mspecttllns
Signature
Permit Valuation 5U7J- r7.)
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Your Building Permit When Approved
1-l--r " a
Date
1- 2-- OJ
Contractor's License No. Date
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-;2-1/1
ThIS IS to cert that thc request in the above applicatIOn and accompanymg documents is m accordance with the City Zllning Ordinance and may proceed as requested. TIltS dllcument
when signed by the City Planner constttutes a temporary Certificate of Zonmg compliance and allows Cllnstructton to commence Before occupancy, a CertIficate llf Occupancy must be
issued
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any