HomeMy WebLinkAboutBuilding 08-0098
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CITY OR PIUOU LiKE IlUILDINC PEIlMIT.
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
n at bottom)
/425/
Flf)i6(L
flU
I)t
Gate !tee 1 d
3. i Z- . 08
I White
Pink
Yellow
File
City
Applicant
PERMIT NO'Ot}. 60
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) OftV/f)
D/9L,/~ '7
p /5 8/'--/2-
/7V
Ilc
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
6It-?'!'j -3 )LO'
I
(Phone)
(Phone)
TYPE OF WORK 0 New Construction OOeck DPorch ORe-Roofing )?Re-Siding OLower Level Finish 0 Fireplace
DAdditlon DAlteratlOn o Utility Connection
CODE: DI.R.c. DI.B.c. o Mise
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 Ihat I have furmshed mformatJ()n on this apphcatJ()n which IS to the best of my knowledge true and mITec!. I also certIfy that I am the owner or authOrized agent I"r the
,lbllVt'-mentwned properly and that all Cll11strUCl1on WIIl cont\,rm to all CX1Stl11g state and local laws and will proceed 111 accordance with submllted plans I am aware that the bUlldl11g
()ftici;lI (an revoke thiS permit for Just cause Furt ore, I hereby agree that the City official or a designee may enter upon the propeliy to perform nceded rnspl'ctlof1S
X Lf/V L_ . 3 -/2-0~
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
i Penalty $
I Plumbing Permit Fee $
i Mechanical Permit Fee $
Sewer & Water Permit Fee I $
I Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
BlIildlllg Un!clal
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
$
ThiS IS to certify that the request in the abnvc application and accompanYing documents is in accordance WIth the City Zoning Ordinance and may procecd as requested ThiS document
when signed by the City Pl<loncf constItutes a temporalY CertIficate of ZOl1l11g compliance and allows construction to commence. Bcfurc occupancy. a Certificate of Occupancy must be
issued
Planning Din~ctor
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9851l, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372