HomeMy WebLinkAboutBuilding Permit #11-0807 y o❑�- c� o�a❑ao =� o y�
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Q� P ����' CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
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,`.,, , TEMPORA.RY CERTIFICATE OF ZO1vING COMPLIANCE
�"' '�s�-�` AND UTILITY CONNECTION PERMIT
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1. White File PEltlrl� NO. // �j D�
2. Pink Ciry
3. Yellrnv Applicant � �f
Please e or rint and si n at bottom
ADDRESS 15153 Oak Ridge Circle SE ZONING�ot�ceuse�
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) Robert Nowak (Phone) 952-440-8095
Address Site
BUILDER
(Company Name) Renewal By Andersen (Phone) _651-264-4777
(Contact Name) (Phone)
Address 1920 Coun Road "C" Wes Roseville MN 55113
TYPE OF WORK CI New Construction ❑ Deck � Porch ❑Re-Roofing [�Re-Siding ❑Lower Levei Finish ❑ Fireplace
[] Addition � Alteration � Utility Coneection
CODE: ❑ I.R.C. ❑ I.B.C. ❑ Misc Replace 2 Windows within exiting openings._
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROIECT COST/VALUE $_3,406.00
Division: 1 2 3 4 5 (excluding land)
I hereby ceRify that I have fu 'shed information on this application which is to the best of my ]mowledge true and conect. I also certify that I am the owner or suthotizad agent for the
above-mentioned property that &11 constructi 'll conform to all eausting state and local laws and will proceed in accordance wiUt submitted plans. I am aware that the building
official can revoke tlus perm for just cause. F ore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X 20130983 17/AUGl11
Si ature Contractor's License No. Date
Permrt Va uahon Park Support Fee # $
PermrtFee S SAC # a
an ec ee $ Water Meter Size 5i8", l $
taie urcharge $ Pressure Reducer S
Penalty $ Sewer/Water Connection Fee # $
P um mg Permrt ee $ Water Tower Fee # �
Mechanical Permit Fee $ Builder's Deposit $
5ewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved •
Buildin Official Date
This is to certify t6at the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. T6is document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of pccupancy must be
issued.
Plam�in Director Date S' Canditions, if �y