HomeMy WebLinkAboutBuilding Permit #11-1136 � O p� C� O��OO� � O D =c�
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��% p � 1 �'P CITY OF PRIOR LAKE BUILDING PERNIIT, Date Rec'd
,`�� �,' �` �l� TEMPORARY CERTIFICATE OF ZOlVING COMPLIANCE
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"� U�_J`'� 1� AND UTILITY CONNECTION PERMIT
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2: � �;�. PERMIT NO. �(,� I��
s. Yd�ow n��
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Ylease or and s at bottom
ADDRESS ZONING �o� �>
/ Zdl �A�r� �L�D�E e+f� S�
LEGAL DESCRIPTTON (o�« use only)
LOT BLOCK ADDITION PID
�x� A?��� �n►� �,eK� G���N� �h qsz•4ys- ���
(Address) S//�h
BUII.DER
(Company Name) I�E� �� �xT�� S (Phone) G t2 •�+Qo • 3Zt4
(Contact Name) G��r.lL �[�2V �S� (Phone) roi2- s�7� .4�� Z
(Ad.dress) /23 Z c 7/ tr4.�c � I�A+� cait� ,n,�, � r
TYYE OF WOBS ❑ New C.o�oroction � ❑Po�ch �te-Roobmg �ReSiding OLowa Levd F'mieh ❑ Fireplace
�Add,iGOn � []Utility Connecti�
CODE: B.C. �.B.C. p 1vlisc:
T�pe of on: I II III N V A B
Occapaac� Gmup: A B E F H I M R S U PgOJECT COST/VALUE s I� 049 !
Div)sion: 1 2 3 4 5 (ezctnding land)
I hereby oeRify tl�at I 6ave fittnished infoimation � ihis application which is to the bcst of my Imoavled8e ht� and oasrax. I also oemfjr that I am the owna a� a�a�ized agmt for the
above-mentioned pmpaty a� that alt coa�sauctian w�l confazm bo all eaisting stau and loral laws and wnll prooced in amozdanoe with sobmgoed plans. I am aware that the buildiog
officiat can ma�Oe ' pecmit far just cause. , I haeby agee that the chy offiaal or a designce may enter � dce properiy to pec6oim needtd'mspect�ms.
x $e.b3o393 G�tiy z���3) �o Zy ��
Signatiue Contcactor's I.icense No. D
Permit Valuation 2 Q �', Pazk Support Fee # S
Pemnit Fee � '' «7 -- SAC # $
Plan Check Fee $ . Water Meter Size 5/8"; 1"; S
state surcnarge a �- _— rress,�re xea,wer a
Penalty $ Sewer/Water Connecbion Fee # $
Plumbing Permit Fee $ Water Tower Fee # E
Mechanical Permit Fee S Builder's Deposit S
Sewer 8c Water Permit F� $ Other S
Gas Fireplace Permit Fee $ TOTAL DUE S a( `
This � sabmes Yom '� pe�mic •ed Paid 7 Rece' o.
Date D / B
� 2 t�
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This is to oertify that the request in the above application and acoompanying docvmmt4 is in a000idance with � Cily 7,oning Oidioance and may panoeed as raquesbed. This doatment
wfien signed bq the Ci[y Planner a�timtes a tempa�acy CaRi6caoe of Zoning oompliana and allows oons�ud� to oommena. Befure ooa�pancy, a Catifi�be of Oo�opa�.y must be
issued.
Pl�g 1)irecta I�u Spacisl Canditiam4, if any
24 6oar ootice for a0 inapccHoas (952) 447 9�{S0, faz (952) 447-4245
4646 Dskota Sireet 3.E., Priar Lske, Miaaesota 55392