HomeMy WebLinkAboutBuilding 06-0453
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
h, l () b
n at bottom)
f1- 20 f
White
Pink
Yellow
I PERMITN~
File
Cily
Applicant
ZONING (office use)
WOO\
VieW LOt/r-r s.e.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
:r~'v LtJcH
(Address)
(Phone)
rS-2-4/Z-7I~
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Conne tion
CODE: OLR.C. OLB.C. o Misc.
Type of Constmction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certify that I have fi.Jrmshed Information on this applicatIOn which IS to the best of my knowledge true and COITecl. I also cerltfy that I am the owner or authorIzed agent for the
above-menltoned property and that all constructIOn Will COnf(lrm to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke 1115 pe 'mlt r t cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the propelty 10 perform needed inSpectIons
/-- :fC/ij- () 6'
x
Signature
Permit Valuation 2,.500. DO
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildll1!! Ot1icial
Date
Contractor's License No.
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 $ 7(,.Ot)
i~1NO
Paid
Date
7 tl.~f"
This IS to certify that the request in the above applicatIon and accompanYlOg documents is In accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the CIty Planner CllnStllutes a temporary Certificate of Zonmg compliance and allows constructIOn to commence Before occupancy, a Certificate of Occupancy must bc
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372