HomeMy WebLinkAboutBuilding Permit #11-1105 g O❑ p n O�OOO❑ � O D ZC)
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�i� ��� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� I� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" �� �' AND UTILITY CONNECTION PERMIT
�
r hNES��
�. `"h'� F'�e pERMIT NO. �A
3. Yel ow A 1� l� �/V �`-/'
�C3SC Ot � t 811d Sl 8Y b(ILi0111
ADDRESS ZONIlVG �oe�« ��
S g o 7 ) /+��c.+�' T o`� � �. �. �r � 0✓ d 0..��2. �� S
LEGAL DESCItIPTION (o8ice use onty}
LOT BLOCK ADDITION PID
OWNER
(Name) �O � 1 r� mf. �✓'e (Phone)
(Address) sg a� �,�•-.�v Ir0.1 � �.C�. P '� p/' o(�.l�.2 f�� SS3`�a
BuII.nEx l3�Q�� C�� � `?sa-- yt-r`1 � K�l 8 R
(Company Name) � �� � �C. . (Phone)
(Contact Name) J � `� � � (Phone) �/ � — �� ^ � � �
(Address} `'����1' /�o�,�o�� �t S;� ,/ rtbr �c�,� �'✓)� SS3��
TYPE OF WORK ❑ New Construction �Deck �Porch -Roofing �Re-Siding �Lower Level Finish ❑ Fireplace
QAddition []Alteration QUtil'rty Conne on
CODE: �I.R.C. �I.B.C. ❑ Misc:
Type of Constcnction: I II III IV V A B / ��
+Dccupaacy Group: A B E F H I M R S U PROJECT COST/VALUE S (� �
Division: 1 2 3 4 S (excluding land)
I hereby ce�lify that I Yave fumished information on this app&cation wluch is to the best of my knowiedge true and correct. I atso ceitify dtat I am the owner oz authorized agent fa� �e
above-menaoned pmperty and that alt constructi� wilt oonForm to all existamg srate aad ]ocal laws and will proreed in accordance with submitted plans. I am aware that die building
official can revoke tltis pecmit for just cause. Furtheamore, I hereby agree that the city official or a designee may enter upon the property to perform needed ctions.
X ao�3�l/OJ lU/ lg/1/
i Contractar's License No. Date
Permit Valuation Pazk Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee S Water Meter Size 5/8"; 1"; $
Siate Surcharge $ Pressure Reducer $
Penalty $ SewerlWater Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Pemut Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ ,�
This Application Becomrs Your Smlding Permit When Approved Paid Recei t N.
Date 1 ' B �
Build' Ot�'icial I�te �`
lhis is bo certify that the request in the above applicadaa and accompanying documents is in accordance with the Gty Zoning Ordinance and may proceed as requemd. This docvment
when sigaed by the City Ptanner c�nstitutes a temporary Catiflcate of Zoniag compliance and aitows constcuctian u commence. Before ocvcupancY. a Ceitificate of Oa.npancy arvst be
issued_
Plarming Directat Date Special Conditions, if any
24 Lonr notlee for a!1 ivapectlons (952) 447-9850, faz (952) 44�-4245
446446 Dakota Street S.E., Prior Lake, Minaesoq 5539Z