HomeMy WebLinkAboutBuilding Permit #11-0375 3 O❑I� C� ❑ ❑OO❑ _� O � ZA
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� � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec d
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �- �,/
" "' AND UTILITY CONNECTION PERMIT
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j �'NES��
' `�'''"� F `'` PERMIT NO. ! 75
2. Pink City ,
3. Yellow Applicant
C38C OL a11Q S� �Y LOt[01i1
ADDRESS ZONING (os'iae use�
� ��
LEGAL DESCRIPTION (oflFice us� only)
LOT BLOCK ADDITION PID
OWNER L l
(Name) %���C f�'-G. /I Z (Phone) �S�o� � ��6 - l��.S`�
(Address)
BUII,DER
(Company Name) s'-G'�-�, ,� i+'1 rS' �- .�. v �o���,� � G L �� (Phone) G La2 — �2 � - � Q�
(Contact Name) _.�a2 (Phone)
,
(Address) Y v-C � �YStJ
TYPE OF WORK ❑ New Construction ❑Deck �Porch �te-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
�Addiaon �Alteration ❑Utility Connecrion
CODE: �I.R.C. �I.B.C. �'lvtisc: �ur �T.ZC� ,�� BK �a� d- �tic<r k: �c �
'I�pe of Constcuction: I II III TV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE S! � Lhdo_ —
Dhivis�o� 1 2 3 4 S (ex ' land)
I hereby cer[ify that I have furnished information on this application which is to the best of my lmowledge true and correct. I aLto certifj+ that I am the owner or authorized agent fior the
above-menrioned property and that all rnnstruction will conform to all existing state and local ]aws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke this ermit for just cause. Furth ore, I hereby agree that the city official or a designee may enter upon the properry to perform needed inspeclions.
71/.! i i� '�' ��
x _ a�� '�� oZb,SY_I Y��('s �'C3 - //
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
P��ty $ Sewer/Water Connection Fee # $
Plumbing Pernut Fee $ Water Tower Fee # $
Mechanical Pernut Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ �
This Applicatton Becomes Your Bnilding Petmit When Appmved Paid , Re t TIO.
Date � /3 B
Buildin Official DaYe
This is to catify that the request in the above applicadon and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This docu�nt
whrn signed by the City Pianner constitutes a rempoxary Ceitificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Dato Spacial Conditiar�s, if any
24 6our eodce for atl iuspecHons (952) 447-9830, faa (952) 44?-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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