HomeMy WebLinkAboutBuilding 06-0901
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1 White
Pin~
Yellow
/0/0"
I PERMIT NO. tJtc -tJCJO I
File
City
Applicant
ZONING (office use)
"- 3233
V.... (.. L,t'"
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
OWNE\\. ~'.~\
(Name) l. U
(Address) \ ~
~ BUILDER <; "\.11I4.(..
(Company Name)
I (Contact Name) S"'~
(Address) ~"\"\t...
PID
(Phone) Cfl5;} - dOl (, - ;> ~ "33
(Phone) ~".,..., (..
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch Rl)ze-Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
OAdditIon OAlteration OUtility Conntct~n
CODE: ~I.R.C. DI.B.c. o Misc.
Type of onstnIction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
"'
I hereby certily that I have ImnIshed Inlilrmauon on thIS application which IS to the best of my knowledge true and correct. I also certify that I am the owner m authoflzed agent lilr the
above-mentIOned property and that all construction WIll conl,)rm to all eXisting state and local laws and will proceed 10 accmdancc with submitted plans I am aware that the blllldlng
official can reyo mIt for Just Irt crmore, I hen: gree that the CIty official or a deSignee may enter upon the propelty to perform needed lnSpectlons
/6/r If} /I
Date
x
Signature
Contractor's License No.
Permit Valuation
Permit Fee $
Plan Check Fee $ -
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I", $
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # $
Builder's Deposit i $
Other $
TOTAL DUE $ 7~,oo
This Application Becomes Your Building Permit When Approved
B~ ~()-
I lluildlllg Urticial
Paid
Date
~.7;/~
I Receipt NO~2. '-( (,,/
B Y ,---:;z.
1(J4-/c ~
IYale
ThiS IS to certify that the request 111 the abllve application and accompanY1l1g 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 CertIficate uf Zon1l1g compliance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be
isslled
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372