HomeMy WebLinkAboutBuilding Permit 07-0934
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
\ ,1..\ 0
w"edvl'W
] White
Pink
:I Yellow
I PERMIT NO. () 7- 0 931- I
File
City
Applicant
ZONING (office llse)
( +.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
J D ~ ~ ltfL- ~ ) tiS: u,
\1110 W"OdVltw
~iL
Lt.
(Address)
(Phone)
BUILDER
(Company Name)
(Address)
lJV ~~ {\.v- j~'" J
\(t:lll'"t~ .
S~4
C b '^J f-y lA- l h C1l--~
(Phone) h 5 f- 4 3 q - <( 12 0
(Phone)
(Contact Name)
~
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
OAddition OAlteration o Utility Conne tl0
CODE: DI.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
III
H
2
IV V
I M
3 4
A
R
5
I
E
II
F
I
o Misc.
B
S U
Lf J S5 q-
PROJECT COST IV ALUE
(excluding land)
$
I hereby ('('nity that I have furnished mformation on this application which is to the best of my knowledge true and correct. I alsu certify that r am the owner or authOrIzed agent for the
abllve-mentlllned property and that all constructllln wlll conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans I am aware that the bUlldmg
~flcial can revoke tlus permIt ['lIlust c] ~ermore, I hereby agree that the CIty OffiC~ ~ a;Sl~; m~ ~t~ upon the propelty to perf'Jrm needq :/}1tl~l~ 1
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee i $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
IlulldtlH! llfticlal
Date
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 $
ThiS IS to certify that the request m the above applrcatlon and accompanymg documents IS m accordance with the City loning Ordmance and may proceed as requested Tlus document
when .signed by the City Planner constitutes a temporal)' Certificate of Zonmg complIance and allows construction to commence Before occupancy, a Ccrtlticatc llr Occupancy must be
Issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) ....7-9850, fax (952) ....7-..2..5
4646 Dakota Street Prior Lake, MN 55372