HomeMy WebLinkAboutBuilding 06-0804
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Phone)
OWNER
(Name)
Date Rec' d
7,/.,0 ?
I White
Pink
Yellow
I PERMITNO'6t,08t7~1
File
City
Applicant
ZONING (office use)
PID z.<"": 4 rt: (J 1, ~ , (j
(Address)
(Address)
TYPE OF WORK 0 New Construction ODeck OPorch
OAddition OAlteration OUtility Conn
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
(Phone) G,J2- - 5''1 D $59
(Phone)
ORe-Siding OLower Level Finish 0 Fireplace
o Mise.
B
S
PROJECT COST IV ALUE
(excluding land)
$
U
I hereby certify that I have hlrmshed mt,)rmation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
above-mentlOned property and that all construction will conform to all eXIsting state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
official can revoke this permit for Just cause Furthermore, I hereby agree that the City official or a designee may enter upon the propeny to perform needed mspectIons
J ! .#,.....
X t<k . q '" i - Dh
Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Permit When Approved
BuildUl!! Ofticial
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fec # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $
ThiS IS to certify that the request in the above applicatlOn and accompanying documents is in accordance with the City Zoning Ordinance and may procecd as requested TillS document
when signed by the City Planner Cllnstltutes a temporary Certificate of Zonrng complIance and aUnws constructIon to commence. Before occupancy, a Certificate of Occupancy must be
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