HomeMy WebLinkAboutBuilding Permit #11-0887 ; ❑ o� c� a�aaoo � o a Z�
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„���'^` CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� �'� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �'-f �y
. ” `� AND UTILITY CONNECTION PERMIT ` � `{ ��
�
r �'NES��
�.�, '�S' ��� �. Wh,�e File pERMIT NO. �� ����7
2. Pink City
3. Yellow Applicant
lease e or rint and si n at bottom
ADDRESS ZONING (oeece use)
'f
LEGAL DESCRIPTION (oflFce use only)
LOT BLOCK ADDITION PID
OWNER '
(Name) C ! 2 /" (Phone)
(Address) s �
BUII.,DER (� �
(Company Name) �� �te�c�s�e n� �.�G (Phone) �-�aZ �� S�S�
(Contact Name) (Phone) �l mZ .3�g BSCo/�
(Address) �,Yj � / J �
TYPE OF WORK ❑ New Construction ODeck ❑Porch �-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition �Alteration QUtility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Conshuction: I II III N V A B p e c
Occupancy Group: A B E F H I M R S U PROJECT COST/VALLTE S� O��
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have fumished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
above-mentioned pmperty and that all construdion will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
oflicial can ke this permit for just cause. Furthermore, I hereby agree that the ciry otFicial or a designee may enter upon the pmperty to perform needed inspe 'Ons.
X � �-��` � � - �- aa �� 3a� �� s.,
Signature Contractor's License No. Date
Permit Valuation U Park Support Fee # $
Permit Fee $ �,� 7 SAC # $
�
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ � U� Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Perxnit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ �'7
This Applicarion Becomes Your Building Perntit When Approved Paid Recei t NO.
Date — t B
.sZ v Gl'�fUI
Buildin Official Date
This is to certify that the request in the above applicarion and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certi6cate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota SS372