HomeMy WebLinkAboutZoning (Patio) Permit 09-0019CITY OF PRIOR LAKE B
TEMPORARY CERTIFICATE
AND UTILITY CONNE
(Please type or print and sign at bottom)
ADDRESS 3 3 5-6 w% / vt/ /o rS-f irz s „veil
L 4.ie AA AI 5537?
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
OWNER
(Name)
(Address)
lit1�I1,e 1n
BUILDER
(Company Name)
(Contact Name)
(Address)
IT,
MPLIANCE
I White File
2 Pink City
3 Yellow Applicant
TYPE OF WORK ❑ New Construction ['Deck ❑Porch ❑Re -Roofing ❑Re -Siding
❑Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C.
Type of Construction: I II III IV V A
Occupancy Group: ABE F HI MR
Division: 1 2 3 4 5
B PROJECT COST/VALUE
S U (excluding land)
Date Rec'd
#0/9-77 0
PERMIT NO. 0 9 0 0 / 9'
ZONING (office use)
PID
(Phone) - 7 y 7- 6 yy
(Phone)
(Phone)
❑Lower Level Finish ❑ Fireplace
p4-r%O
I hereby certify that l have furnished information on this application which is to the best of my
above -mentioned property and that all c struction will conform to all existing state and local
official can revoke is permit for lust se Furthermore, I hereby agree that the city official or
Signature
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 •;r� 's Your Building Permit When Approved
Buildnl
Official
J‘,Uq
Date
1
knowledge true and correct. I also certify that I am the owner or authorized agent for the
laws and will proceed in accordance with submitted plans. I am aware that the building
a designee may enter upon the property to perform needed inspections.
aq
Contractor's License No. Date
Park Support Fee
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
Receipt No.
By
This is to certify th "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�ity Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence Before occupancy, a Certificate of Occupancy must be
issued
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