HomeMy WebLinkAboutBuilding Permit 11-1154 F ❑ C. ❑ C) ❑- Cl❑❑❑❑ -4 O > E
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
c TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
"` �' AND UTILITY CONNECTION PERMIT
4 "I N '`-6C
I. White File
2. Pink city PERMIT NO. //... / / f y
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
(lst5 Sts r tir c1, , Frc ichr Tv .SE ► Pricy i A AN 553'7a
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID Zs cl l C I. Gus . ,.?--
(Name) R J(_ U l 0 \( QOPAixly \ j IJt∎14 } . P - O,L\ (Phone) 6/53 - ` , N 2 _. 1 o ova•
(Address) , �cL. :R _!v'c\�iihke �� cc G\ `,p 1NW `5 - 3��''j . •
BUILDER S ... ` ► C (Phone) q o f ' •
1 - `l lu1 `) t I
(Company Name) Al ``tt �Xtt )� �C TC Y 1 ► �C. • (Phone
(Contact Name) 1 C (Phone) c75 yu(, - zi
(Address) k) 00 X 1 CD f .fit Le v' 11 IL 6 M N
TYPE OF WORK ❑ New Construction ['Deck ['Porch ❑Re- Roofingte- Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ['Utility Connection
CODE: DI.R.C. DI.B.C. ❑ Mme:
Type of Construction: I 11 III IV V A B !) . c " b
Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE S
Division: 1 2 3 4 5 (excluding land) •--• J / Q °—
I hereby • • ' th. I have furnished information on this application which is to the best of my lmowledge true and correct. I also certify that I am the owner or authorized agent for the
above -m , .on . . , • . and , all . . ... -• will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
.. is A , for ' -- i ermore, 1 hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
► A 4 1 —_ 1 ` . _ ( 3 131 /0.1 . cA / I
jf . i Contractor's License No. Date
Permit aluation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 7 9- 7S
This Application Becomes Your Building Permit When Approved Paid 7.7. 7s Receipt o. IQ t 4 S S 6
Date /0)2 7/8 BY t -
Building Official Date /
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 Cutificate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fa: (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372