HomeMy WebLinkAboutBuilding Permit 09-0704
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
9-r.Oj
at bottom)
~:~~ew ~l~licant I PERMIT NO. 01 0 104
3.lz..3
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
ZONING (office use)
OWNER
(Name) ~lM.() t~ J
(Address)
(Phone)
GS".l-l~l- 01"2."\
b.~e.\'\ be......~ t.('
r
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK. 0 New Construction o Deck DPorch
DAddition DAlteration DUtility Conn
DLower Level Finish 0 Fireplace
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
I
III IV V
HIM
234
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
x
I hereby certify that I have filrnished mformation on this application which is to the best of my knowledge tme and correct. I also certify that I am the owner or authonzed agent for the
above-mentIOned propelty and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
ollicial can revoke this permit for Just c se Furthermore. I hereby agree that the City ollicial or a designee may enter upon the property to perform needed mspectlOns.
q/9/01
Date
Contractor's License No.
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
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
This Application Becomes Your Building Permit When Approved
Building Ollicial
Date
#
#
#
#
$
$
$
$
$
$
$
$
$
ThiS IS to certify that the request in the above applicanon 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 Zonmg compliance and allows construction to 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