HomeMy WebLinkAboutBLDG 07-0974
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CITY 0 OR LAKE BUILDING PERMIT,
,fl TEMPORARY CERTI ATE OF ZONING COMPLIANCE
SL;:rJ~ tp lJb UTILITY , ONNECflO~,~E~T
Pmk City
Yellow Applicant
ADDRESS "--
1<l7S<c
/1
A/I .s L
LEGAL D. .. ESCRI;eIJON (office uss.,onlJ)
.&' . YLlti-,;;;)..5/1(p
LOT ~BLOCK ADDITION
Date Rec'd
/0.907
~
I PERMIT NO. 07_ 0'774--1
ZONING (office use)
j(Jli'AF5 tl.j (vvc
OWNER
(N ame) WI(.. (. 'Ke ":J H e 11""4..
(Address) / ~
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BUll.DER __
(Company N ame))3lf>v.fI..l /t J/ /9.-vLJ
(Contact Name) :':::;-"/1'J
(Address) 7i37o W#.jr /[L"lU,..I,(J
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PID d:;S" /
(Phone) 9if '9 - ,;).3 3 - / 93.5'
6." ~ ;~ ;7,-,-
(phone)
(Phone)
~S, - ~ t.J '1- ~S/.'3
(fl.)/ - .;)'10 - I~..).I
TYPE OF WORK D New Construction DDeck DPorch ~Re-Roofing
DAddition DAlteration DUtility Connection
CODE: ~.R.C. DI.B.C. ~MiSC':'\.~'; -7)KIfM
Type of Construction: I II ill IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
e-Siding
DLower Level Finish
D Fireplace
\ I
~A4"~
PROJECT COST /V AL UE $ /..:s-:..;./ 00
(excluding land)
g2
I hereby certifY that I have furnished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or authorized agent for the
above-mentioned 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 building
official can revok~s per~ for just cause. Furthermore. I hereby agree that the city official ora designee may enter upon the property to perform needed inspections.
X ~ GaL c::l O'-l3Dtfc; / /0 - B.. "7
Signature Contractor's License No. Date
Permit Valuation
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
Building Official
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 in the above application and accompanying 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 of Zoning compliance and allows 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
4646 Dakota Street S.E., Prior Lake, Minnesota 55372