HomeMy WebLinkAboutBuilding 08-0327
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec '}
~, ~if
1 White
Pink
Yellow
File
City
Applicant
PERMIT NO.
n at bottom)
ADDRESS
05(O--:{.
( LW)i.Ac....-
lA-eft
~:+9V
IlL-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
(Phone)
(Address)
BUILDER .....
(Company Name)
(Contact Name)
(Address) It{
,j --c C TCAL~4 r-- Oi'Vd :r~hOne)
E. I I-Vt7-,",,--..qr--- (Phone)
~.fL( 1)L-L Q;'J6-
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level finish 0 fireplace
OAddition OAlteration OUtility Connection
CODE: OLR.C. OLB.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 /V ALUE
(excluding land)
$
I hereby certily that I have hlrmshe,1 ml'Jrm tlUn on this applicatIOn which IS to the best 01 my knowledge true and correct. I also certify that I am the owner or authollze,] agent lor the
IIlctlon will conform to all eXlstmg state and local laws and Will proceed in accordance with submitted plans I am aware that the btlIldmg
urthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propeIty to pert(Jlm neede~):tI3'_ 02
Contractor's License No. Date
x
Permit Valuation
Park Support Fee
#
#
$
$
$
$
Plan Check Fee
$
$
$
$
$
$
I $
$
SAC
Permit Fee
Water Meter Size 5/8"; I";
State Surcharge
Pressure Reducer
Building LJrticlal
Date
Water Tower Fee
Penalty
Plumbing Permit Fee
Mechal1lcal Permit Fee
Sewer/Water Connection Fee
#
#
Sewer & Water Permit Fee
Builder's Deposit
Other
Gas Fireplace PermIt Fee
TOTAL DUE
-
This Application Becomes Your Building Permit When Approved
ThiS IS to certify that the request in the above applicatlOn and accompanYll1g 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 Ccrtiticatc of ZOl1lng compliance and allows constructinl1 to commence Befnre nccupancy, ;1 Certificate of Occupancy must be
isslled
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9R50, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372