HomeMy WebLinkAboutZoning (Patio) Permit 09-0014CITY OF PRIOR LAKE BUILDING PERMITI
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
OWNER
(Name) t ✓ d 00
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
CODE: ❑I.R.C. ❑I.B.C.
Type of Construction: I
Occupancy Group: A B E
Division:
I White
2 Pink
3 Yellow
File
City
Applicant
Date Rec'd
za_o q
PERMIT NO. 09 0 0/¢
PID
ZONING (office use)
(Phone) Q61/43 —T 3c' " 00 f
(Phone)
(Phone)
TYPE OF WORK ❑ New Construction ['Deck ['Porch ❑Re -Roofing ❑Re -Siding ❑Lower Level Finish ❑ Fireplace
❑Addition DAlteration DUtility Connection
p Misc.
II
F
1
III IV V AB
HI MRSU
2 3 4 5
PROJECT COST/VALUE $
(excluding land)
I hereby certify that I have furnished 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 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 per for lust cause Fu ermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspection
1`� �..- mom- inspection
Si: tub Contractor's License No. bate 7
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 Applica t o . • co es Your Building Permit When Approved
"i Dina cial
Date
This is tecertify 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
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
Pa & ....
Date S 2v,e 7-
/
Rec_ej�e-I.,.
By —
Planning Planning Director
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