HomeMy WebLinkAboutBLDG 07-0254
CERTIFICATE OF ZONING COMPLIANCE
UTILITY CONNECTION PERMIT
Date Rec' d
4. z.3. 07
1. White File
2. Pink City
) VeUow Applicont
I PERMIT NO. 07. 0254- I
I ZONmGC__1 I
\ f.cF;C
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 26. 09S-. ~()~. 0
I OWNER b~ ~ ~~
(Name) ;.--, '-t~J I C "-- _
(Address).. ~_ c; .~,
(Phone)
(D\7- Pll7- CJ.:s~ I
~=:Name) \L'<+-0 E..'')('~ iC::Jt<:." \ \....~ \
..~ f\. '" - 7") /',../ C' ,
(Contact Name) ~ ~ ~ ~{ ~::-)..::>
(Address)' ()ZD \ et::..l..l..D
I 7 -? ,.- /. ,L,C1C't
(phone) lo'J - "7 \ ~ - ulv I
(phone) 6'\L- 4\8.. ~t44Lt
cP~E::. (\/\ ~ .
TYPE OF WORK 0 New Construction ODeck OPorch ORe.~fi~ ORe-Siding OLower Level Finish 0 Fireplace
OAddition DAlteration o Utility Connection ~isc. ~(r:2_-Jrl::t..~CD _
CODE: oI.R.C. OI.B.C. PROJECTCOST/VALUE S '-.S~, ~
Type ofCoostruction: I n m IV V A B (excluding land)
Ocaapancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
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 authonzed agent for the
above-menltoned propet1y and that aU construction will confurm to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildinl
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X - " ,(de L-X)~ ~37Z ,'/ 01
Signature . Contractor's License No. , Da
Permit Valuation
Pennit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Pennit Fee
Gas Fireplace Permit Fee
Park Support Fee
SAC
#
#
$
$
$
$
$
$
S
S
$
S
$
$
$
$
S
S
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
Buildin Official
Dale
This Application Becomes Your Building Permit When Apprond
ThIS IS to certify that the request in the above application and accompanyinl documents is in accordance with the City Zooinl Ordinance and may proceed as requ,'SlCd. This document
when silncd by the City Planner constitutes a temporary Certificate of Zooinl compliance and allows construction to commence. Before occupancy, a Cl"l1ificatc: of Occupancy must be
issued
PIannin8 I>irectoi
Dare
24 hour notite for alllnspettionl (~2) 447-98~. fill (~2) 447-424!1
16200 Eagle Creek Avenue Prior Lake, MN 55372