HomeMy WebLinkAboutShed Permit 08-49
Date Rec' d
/0, 23.08
SIfc:J-)
PERMIT NO. () a. 4-f
,
ZONING (office use)
CITY OF PRIOR LAKE B
TEMPORARY CERTIFICATE
AND UTILITY CONNE
White File
Pink City
Yellow Applicant
(Please type or print and si~n at bottom)
ADDRESS
I G:, V ~ Q.. vJ I (l OW W~ 00 c.l L Se...- I? rl tI r L.. (((. , /"t1J.
ss '3' "2-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
~c:.t.~u
~ \A.~v 12. -tf-c.r
,
(Phone) tfQ.- 4 'f~ ~ '2.lD '2-
(Address) Sa..~ Q,." a,\"ovc...
BUILDER
(Company Name) "5'c...fI'C.. c;..S' a..L.o~
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK o New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish o Fireplace
OAdditlOn OAlteration OUtIhty ConnectIon ~tSC /2-/
CODE: DI.R.C. DI.B.c. ,j1f&iJ /0 K
Type of Construction: I II III IV V A B PROJECT COST /V ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certity that I have turnIshed mformation on this applicauon which is to the best of my knowledge true and correct. I also ceruty that I am the owner or authOrIzed agent for the
above-mentIOned property and that all construction will conform to all existmg state and local laws and will proceed m accordance with submitted plans. I am aware that the buildmg
otflClal can revoke thIS pelmlt for .lust cause Futthelmole, I hereby agree that the City offiCial or a destgnee may enter upon the plOperty to pertorm needed mspectlllns
X ~~f.i' ~ _ ~-z.~(
V (SIgnature ~ Contractor's LIcense No { Date ~
--- ----
Permit Valuation
Park Support Fee
SAC
#
#
Permit Fee
$
$
$
$
$
$
$
$
TOTAL DUE
Plan Check Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Water Tower Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
-
Paid .....--- I
Date /0. l-7"f/{
HuilulIlg Ofticlal
Date
$
$
$
$
$
$
$
$
$
6
ThiS tS to certifY that the request 10 the above applicatIOn and accompanymg documents IS 10 accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the Ctty Planner constitutes a temporary Certiticate of Zomng compliance and allows construcuon to commence Before occupancy, a Certtflcate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any
,c. -12' 97(FRII 14:42
PROBE ENGINEERING CO
TEL:612 432 3723
P. 002
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