HomeMy WebLinkAboutBLDG 07-0537
__-- Y OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
----
TEMPORAR CERTIFICATE OF ZONING COMPLIANCE
~OStL ~ .\=:{, AND UTILITY CONNECTI~~".~E~IT &{2 ~ 107
~ ,; . n .i:LiJf7 ;;;,:. ~;;,."... PERMIT NO. en - 0 no 7
A" O;IUAL.
f 'IJ~4. ,tA.: L
ZONING (omce use)
~~,
p", :~~ L.A"..
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER .
(Name) m I c.. h<"L G- j d I ~.J
(Address) '58 5'-1 C A- ~ (J: .,J A-L ~ : d'J <e. Ij( A " L
9 'S.:l - 188- Y J. I ~
$E.
(Phone)
f R : 0.. L 1'+ K<..
BUILDER fA(A'c ~ -<.'i. Tot"" T' ; ~,., J:N<..
(Company Name) (Phone)
(Contact Name) ST~v.e: &/l'rh_ (Phone) (P1).~'J.,S/- ~8'i'
(Address) 91 J. 4ctl... I+vE. /LJ . E. Cclv.....w:,., J.I... ; '" IT> p],.J ~S'J).I
TYPE OF WORK 0 New Construction ODeck OPorch Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration OUtility Connection
CODE: Mi.R.C. OLB.C.
Type of cf~nstruction:
Occupancy Group: A B
Division:
IV
I
3
V
M
4
A
R
5
I
E
II
F
I
III
H
2
o Misc.
B
S U
Cj13J.of
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I have liJrmshcd mformation on this application which 15 to the best of my knowledge true and correct. I also certify that I am the owner or authOrIzed agent for the
Jbove-mentlOned property Jnd that all etmstruction wIll conf()rm to Jll eXIstmg stJte and locallJws and will proceed m Jccmdance with submitted plans I am aWJre that the buildmg
oflletal CJn revoke tlus permit 1m Just cause Furthermore, I hereby Jgree that the CIty official m J deSIgnee mJY enter upon the propel1y to pert(lrm needed mspectllms
~~
Signature
x
JO~3<' " .,
Date
Contractor's License No.
Permit Valuation It 2..~oo, 0 0
Permit Fee $ 7'-1.75
Plan Check Fee $ -
State Surcharge $ 1,25
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
This Application Becomes Your Building Permit When Approved
~c~
16 / 2-1_/d 7
f Date
Ilulldlllg OI1lcial
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 $ ?f.D. 6 0
Paid
Date
7".00
~~e1
Receipt No, ~lfot.fCJ
By ~
..., .
ThiS IS to certify that the leqUl'st in the above application and accompanymg documents is In accordance with the City Zoning Ordinance and may procecd as requested TillS document
when signed by the CIty Planner constItutes a temporary Certificate of Zonmg compliJnce and allows construction to commence. Bcfme occupancy, a Certlticate 01 Occupancy must he
I Isslled
Planning Director
Date
z.t hour notice for all inspections (952) 447-9850. fax (952) 447-4z.t5
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any