HomeMy WebLinkAboutBuilding Permit #09-0111 ��C�'C�D�C�
oF prtr CITY OF PRIOR LAKE BUILDING PERMIT � ��t��
,� A� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
�' � AND UTILITY CONNECTION PERMIT
� �, By
M��'NES��P �. Wh��e File pERMIT NO.
2. Pink City //
3 Yellow Appiicant �
Please e or rint and si at bottom
ADDRESS ZONING (office use)
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LEGAL DESCRIPTION (oft'ice use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
PAT FRIEDGES CONSTR.
BUII.,DER
(Company Name)_ 612-490-8698 (Phone)
(Contact Ivame) 21731 BENTLEY CIRCLE (Phone)
(Address) JORDAN, MINNESOTA 55352
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch -Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Conn tion
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B pROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (exciuding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and conect. I also certify that I am the owner or auffior�zed agent for the
above-mentioned operty and that all constn�ction 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 rev e t is permit for ust cause. rthermore, I hereby agree that the city officiai or a designee may enter upon the property to perform necded inspections.
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re Contractor's License No.
Permit Valuation Park Support Fee # $
Permit Fee SAC # $
Plan Check Fee Water Meter Size 5/8"; 1"; $
State Surcharge Pressure Reducer $
Penalty Sewer/Water Connection Fee # $
Plumbing Permit Water Tower Fee # $
Mechanical Permit Fee Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ $ G--�'
This Application Becomes Your Building Pernrit When Approved ReC t No.
20 1 B
Buildina Otticial Date
By
Thu is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requcstcd. This document
when signed by the City Planner constitutcs a temporary Certificate of Zoning compliance and allows construction to commence. Befure occupancy, a Ccitificate of Occupancy must be
issued.
Planning D'uector Date Special Condi6ons, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Priar Lake, MN 55372
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