HomeMy WebLinkAboutBuilding Permit #11-895 � ❑ ❑� C� ❑ ❑�O❑ � O D =c�
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,,, �'� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� I�\� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �' g � l /
~ � AND UTILITY CONNECTION PERMIT
�
j �'NSS�� S
7. W6iu File PERNIIT NO . � �
2. Pink City
3. Ydlow Applicant
CBSC Ot And � at �N1ttO1LL
ADDRESS ZONIl�TG �o�« ��
Ila �o�' tldt`Kess ���;� S�
LEGAL DESCRIPTION (o�'ice use only)
LOT BLOCK ADDITION PID
OWNER
(Name) �a �' � (�, �� o �a� (Phone)
(Address) ICrqG t,Jc(der �sira:l �
BUII,DER
(Company Name) A cSCc�^- ��e.ss �l u.e � a•. l v� c (Phone) G��° fs'S'� � 7,3
(CoIItact Name) �� w►- Ke- wlcv �-.� (Phone)
(Address) �tK � J� � G,�v�sc�a�c �i�j.� �d'�G
TYPE OF WORK p New Consavcaon pn�cx pPotcn p�-xoosn8 �-siai� pi.ower i.e.�e� Fin�sn ❑ F��
�Addition �Alteration QUt�ity Connection
CODE: �]I.B.C. �I.B.C. ❑ 1�iisc:
1`'pe of Consl�nction: I II III IV V A B
Occupancy Gronp: A B E F H I M R S U PROJECT COSTNALUE � G,, a00. "'
Div,ision: 1 2 3 4 5 ( land)
I herebY �S' t6at I have fivnished informadon at this appluatiai � is to d� best of my Imowted8e hve and crnroct. I also oalify that I am 1iu ovener � atuhrn'iad a�mt fa Uu
abwe-menCaned pmperty that a oceeu . . confiorm to all e�dating staoe and local laws and will pr000ed in acoordana with submimed plans. I am awane d�at tht building
officiat can this rNurmore I hereby agree that the caY officiai � a designee may enter up� Ute propetty to pafotm ne�d 'mspectioas.
X c ` ��� �53 �_ �_ ��
Sig�ature Contractor's License No. Date
Peimit Valuaxion Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
5tate Sumharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Pern►it Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit S
Sewer 8c Waber Permit �ee $ Other $
Gas Fireplace Pe7mit Fee $ TOTAL DUE $ '7s
.
T4is Arrlicatioa Beoomea x�c saildioa retmic when Appmvca Paid , R ' No.
Date
Buildin Official Dabe
This is ro ceriify tUat the request in the above applicati� and aawmpanying documenb is in aaprdanoe wiW the City Zoning Ord'mance and may pmoe�d as neqaesaod. This docummt
when sigoed by the Citp Plauner oonstidt6es a temporary Certi6c-rbe of Zoning mmpliance a� allovvs oonstrucdon to oommtnce. Hefone oocupancy, a Ce�cate of Ooeupancy must be
issued.
Plaooing Dimcxor I�u Special Condilians. if anY
24 hoar noHce for aIl iaspectiona (952) 44'f-9850, fxi (952) 447-4245
4646 D�kota Street S.E., Pr�r Lake, MSnnteota 55372
� PRI �
�;--�� CITY OF PRIOR LAKE BiJILDING PERNIIT, Date Rec d
� �� �� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE '
"�;� � AND UTILITY CONNECTION PERMIT �- Z�� I
d ,�Q �
j �'NES�
L WFtite File pERMIT NO .
, Z. �k �,Ty 1 l. �� Z
3. Yellow Applicsnt
CaSC Or 8Dd 31 SY �l[IttOYll
ADDRESS ZONING (ofl�'ice use>
f��G� :(clof��sz- � a�� S'E:'
LEGAL DESCRIPTION (otfice use only)
LOT BLOCK ADDTITON PID
�WNER , �.� � �.c o c'q, r� (Phone)
(Address) � � �� �c �i,° d �l e s I +' �. ; � � � �r � a t Lu �C .� `!R rJ 3 � � 7 �
BUII,DER
(Company Name) � ��. w•. � r s s ��<.� , E-� � r. 1 �c _ (Phone) � � Z - $'�v c� � 3
(Contact Name) N � a �- � � �.. (� u�-,� (Phone)
(aaa�s) �� �I / Z�-C. .¢�c �� o � /Y !�N �-✓
TYPE OF WORK ❑ New Construction �Deck �Porch �Re-Roofmg ORe-Siding dLower Level Finish ❑ Fireplace
❑Addition �Alteration �Utility Conn n
CODE: �I.H.C. DI.B.C. ❑ Misc:
lrppe of Conshucnon I II III IV V A B
Occapancy Group: A B E F H I M B S U PROJECT COST/VALUE S �v. �'b v� p �
Division: 1 2 3 4 5 (egctuding land)
I hereby certifjr thaL I have fiunished ioformation on this applicadon which is W the beat of my lmrnvledge trae and corred. I also certity tbat I am the owner a� authotized a�ent fa the
above-meuaoued that w7l confoim to all e�risdng state and locat laws and will proceed in acoordancc witL submitted plans. I am awam that the building
officiai can eim�e. I hereby agee that the city official or a designec may enDer upon the pmQerty to petfotm needed inspections.
X �c�G2o ��� 67-a3
Sig�nature Contractor's License No. Date
Pera�it Valuation Pazk 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 # S
Mechanical Permit Fee $ Buiider's Deposit $
Sewer & Waoer Permit Fee $ Other S
Gas Fireplace Permit F� $ TOTAL DUE � �
Tlds apQltcadon Eeoomes Ywr suitai� Pem�ic when Appmvat Paid R i t No.
Date
Buil ' Official Date
This is ro certifjr that the request in ffie above application and accompanying documenls is in aocordance with the Qity Z�ing Ordinance and may proceed as requested This docament
when signed by the City Planner �ns8mces a temporary CatiScare o�' Zoning compliance and allows wnstruc6on roo commence. Hefore occaPancY, a CeatiBcace of Occapaacy mast be
issued.
planoing I�or Dete Spacial Coqdiflons, if my
24 hoar notice for atl inspections (952) 447-9850, fsa (932) 447-4245
4646 Dakota 5treet SE., Prior Lske, Mianesota 55372