HomeMy WebLinkAboutBuilding Permit #11-0977 � ❑❑ n O DOO❑ 'o O D yc�
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec d
� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� AND UTILITY CONNECTION PERMIT
d ,��
hNBS�
t. White Filo
Z. P;,,k c� PERNIIT NO. I I
� � 3. Yellow Appiiant
esae e or t and si at bottom
ADDRESS ZONIl�TG �offi« use>
� I�� �u �dl��,�, f
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDTTION 1'ID
� °� � i2 -Z� -� 9 y�{
(Name) � 1�-�(� �O �"�.e � (Phoae)
(Aadress) ( � l,� C S
(CompanyName) 5 � � t � v � �` � � O''�" �" 7� (Phone) 9 S � � �U � l �!J �
(Contact Name) _,,,��P [i! S G �it-�^-� �`c�..�' (Phone) '3 ZO ' �9 " f � �4
�aaa�s� .
TS�PE OF WORK 0 New Construction �Deck �Porch �`!te-Roofing �Re-Siding �Lower Levd Finish ❑ Fiseplaa
�Addition �Alteratioa �Uti1ity Connection
CODE: �I.R.C. �I.B.C. ❑ Misc:
T�pe of Constnution: I II III IV V. A B �/
Occ�pancy Group: A B E F H I M 2i S U PROJECT COST/VALUB �y. 7 Z'1 . 2 3 ,
Division: 1 2 3 4 5 (eacl ' land)
I haeby artify that I have fluaished lnformation on t�ie appllcation which ls W the best of my. knowtedge trne and mmd. I ateo ardly tlutI am fhe owner tx anfho:ized agmL fbr ihe
above-menHoned aad that s11 ction will confocm to ap e�dsttng state and local laws and wllt proceed in axordaaa with anbmitted plans. I am sware tl�at the building
officlal can revoke permit j uae. Fu�thamore, I hereby agree that the dty offidal or a designee may enter upon the property to perform pedi�s.
X �'GO��.�� �U 2 � �/
Siguature Contractor's License No. Date
Permit Valuation Park Support Fee # S
Permit Fee $ SAC # S
Plan Check Fee $ Water Meter Size 5/8"; 1"; E
State Surchazge $ • Pressure Reducer � S
Penalty $ Sewer/Water Connection Fee # S
Plumbing Permit Fee $ Water Tower Fee # E .
Mechanical Permit Fee $ Builder's Deposit S
Sewer & Water Permit Fee $ Other S
Gas Fireplace Permit Fee $ TOTAL DUE S
Thia AppllcaHon Becomea Your Buitding Permit WLrn Approved Paid •� R i t No.
Date 2 Z. B
Buildin Official Date
This ia to artlty that �e request in the above appllcadon and accompanylag documents is 1n accordance with the Gty Zoning Ordinance and may pmaed aa tequdoM. Thia document
whea e�ed by the City Planner coaatitntee a temporery CettlBcate of Zoniag compliance and allows construction ro oDmmma. Beibre occupancy, a Certl8ca0e oP Oavpancy mnst be
iseued.
Piaoning Director Date S' Condidona, if my
24 6our noHa for alf inepections (952) 447-9850, fsz (9S2) A47-4245
4646 Dakoh Strcet S.E., Prior I,ake, Mioneaots SS:i'72