HomeMy WebLinkAboutBuilding Permit #12-0486 oF rrtt CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
�' � AND UTILITY CONNECTION PERMIT
U �r
M�NNESO�P I. White File pERMIT NO .
2. Pink City ✓
. 3 Yellow Applicant � � ✓
Piease or rint and si at bottom)
ADDRESS / � � 7 � �� � n h D � O � � �( ,(� V � + l� /'� ZONING (of�'ice use)
/� i�- IV
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
O a�VNER �. f�/ �Cbt! �d � (Phone) Q s� � yy 7• T� G D
(Address) �� 3"7 � r" � n 6 0� d t,f / 1 � � / Y G
BUII,DER THD At- Home Service Inc phone)
(Company Name) 2690 Cumberland Pkwy, Ste 300 � f�S`? 3ys' L py 7
(Contact Name) Atlanta, GA 30339-3913 (Phone)
(Address) Lic # 20268257 Ph. 763/542-8826 J b ��
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alterarion ❑Utility Connection 1
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. 5 �"�� n �� W r� P�Q c� M�� / S
Type of Construction: I II III IV V A B PROJECT COST/VALLTE $ 7 a T�
Occupancy Group: A B E F H I M R S U (exciuding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished information on this application which is to the best of my knowledge tnie and correct. I also certify that I am the owner or authonzed agent for the
abuve•menhoned property and that all consnuct'on will conform ro all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
offic' 1 can revoke this permit for just cause. Fu ermore, I hereby agree that the city official or a designee may enter upon the property to perform necded inspecu ns.
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Signature Contr o. Date
Permit Valuation P # $
Permit Fee $ # $
Plan Check Fee $ ater er /8"; 1"; $
State Surcharge $ ressure R cer $
Penalty $ wer/Wat n Fee # $
Plumbing Permit Fee $ a Tower e # $
Mechanical Permit Fee $ r's Deposit $
Sewer & Water Permit Fee $ � ther $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid � ReCei t o.
Date � L . / L B
Buildin � Utticial D�te
This is to certify that thc request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner consfitutcs a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Ccraficate of Occupancy must be
issued,
Planning Director Date Special Condifions, if any
24 hour notice for All inspections (9S2) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
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O '� P�Q�P , _ _ _
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: : Memo
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Date: Friday, January 11, 2013 :
_
To: Janet Ringberg :
_
From: Lynda Allen _ `
. Subject: Building Permit # 12-0486 : :
. 15371 Edinborough Avenue NE _
The memo authorizes the return af the building permit fee for permit # 12-0486. The
homeowners ha�e opted not to ha�e the ivork done.
Permit Refund Amount s$37.38 ($74.75 divided by 2)
Please make the check payable to Elder Jones Building Pernut Service, Inc:: and mail' to:
. F1der Jones Building Permit Seruice, Inc.
l 120 East 80'� Street
Bloomington, Minnesota 55420.1498
. Thank you.
- - -- --
Lynda . All _ _ .
� � g Services Assistant _ _
Phone 952.4479800 / Fax 952.447.4245 / www.cityofprioclake.com