HomeMy WebLinkAboutBuilding Permit 07-0266
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
'1~ 2 ') /l1I,.H~IAI(; i)/IP D T~
LEGAL DESCRIPTION (office use OnIY~ /
LOT BLOCK?- ADDITIONIL-/JOc>
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 07....Z~
ZONING (office use)
/L
12-
PID
OWNER
(Name)
---
(Address)
~ TEvE t/1~J{)AJ
LIt. 2.-'> H~""AfIN&/}IItf)
I
i BUILDER
~company Name)
I
I (Contact Name)
(Address)
/
(Phone) 9~b- ~1(5". 7)>5'
r/frllL
(Phone) /, / l- r8-tJ L-' 3/~o
(Phone) (, /2-. <gO 2- '<6/ dO
'EW /l1'C,&--6t( Ii"
TYPE OF WORK 0 New Construction ODeck OPorch ,X!Re-Roofing
OAdditlOn OAlteration OUtility ConnectIon
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
ORe-Siding OLower Level FinIsh 0 Fireplace
j(t/l{)oF w/7h TJ;}?/t 0 Fr
o Mise
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have furnished mformation on this application which IS to the best of my knowledge true and correct. I also certIfy that I am the owner Ilr <luthouzed agent for the
,1bove-mentlO 'd property and that all construction WIll cont(Jrm to all eXIstIllg state and local laws and will proceed III accordance with submltled plans I am aware that the buildIllg
official can ke IS perml for Just ause F hermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propet1y to perform needed InSpectIons
PI: ) 20 I ~oJ8'f _~ !t-},l- 07__
, Contractor's License No Date
Permit Valuation
Permit Fee
$
$
$
$
$
$
I $
, $
Plan Check Fee
State Surcharge
i Penalty
! Plumbing Permit Fee
~echanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace PermIt Fee
Park Support Fee
SAC
# $
# $
$
$
# $
# $
$
$
$ G....-
I ~~ceiPt No~JffI L
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid ~
Do" f1~(o 1
ThiS IS tu certify that the request in thc abuve applicatlOn and accompanYll1g documents is 1I1 accordance WIth the City Zoning Ordinancc and may procced as requested ThiS document
v,'hcn signed by the City Planner constitutes a temporary Certitkate of Zunmg compliance and allows constructIon to commence Before occupancy, a Certlticate l)f Occupancy mllst be
issued
Planning Director
Date
24 hour notice for all iuspectious (952) -t-t7-9!l5ll. fax (952) -t-t7--t245
4646 Dakota Street Prior Lake, MN 55372
Special Conditioos, if any