HomeMy WebLinkAboutBuilding Permit #11-094 \�
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p F PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE (� � f
AND UTILITY CONNECTION PERMIT l'" ���
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'1�j I. Whi�e File pERMIT NO.
2. Pink City � � /h (, � (
3 Yellow Applican� ��
Please e or rint and si at bottom
ADDRE " _` �,� � �� � A M ZONING (office use)
15 V ` C..�;�� ��-�.�,,/ '2
LEGAL DESCRIPTION (office use onty)
LOT BLOCK ADDITION PID
(Na�m E �r� �2. � �i � � l �` 1 0 �j (Phone) 6 � �`' � 0 U J !� � �
(Address)
BUII,DER I � / K ICi�us �G�¢ �� ' L�.. (Phone) b �� — � � b ` g � �
(Company Name) K K �t �
(Contact Name) � (Phone)
(Address) Cl gEJ 3 ✓,s� i�� lT �� � r o'l �i� SU a
TYPE OF WORK ❑ New Consauction ❑Deck ❑Porch �,Ze-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. � Misc.
Type of Cons�uction: I II III N V A B pROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have fi�mished information un this application which is to the brst uf my knowledge tnie and correcc 1 also certify that I am the owner or authonzed agent for thc
alwve-mennoned properry and that all construnion will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
ufficial can r ke this prrmit for j cause. F rmore, ereby agree that the city official or a designee may enrer upon the property to perform needed mspections.
X ��� 3 �� � � �- j� -r/
Signature Conaactor's License No. Date
Permit Valuation v(� Park Support Fee # $
Permit Fee $ - 7 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
.
This Application Becomes Your Building Permit Whrn Approved Paid �K Recei t NO.
Date a-(b—�t B �i�.�6
�'� �-�! 1
Buildina Utticial Dnte
This �s to certify that the requcst in the above applicanon and accumpanying documents is in accordance with the Ciry Zoning Ordinance and may proceed as rcqucsted. Th�s document
when signed by the Ciry Planner consumtes a temporary Certificaze uf Zoning compliance and allows construction to commence. Befure occupancy, a Certrticate uf Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour noticc for all inspections (9S2) 447-9850, fax (9S2) 447-4245
4646 Dakota Street Prior Lake, MN 55372