HomeMy WebLinkAboutZoning Compliance 12.0061 Shed OF PR / CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /G J /2__ .. x AND UTILITY CONNE PERMIT D
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2. Pink City PERMIT NO. /2 ( /
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/(a96 9 D2 /i7E nvt,
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) N/C-r CT'
'J x r (Phone) (45,9 -4-_ 7 O ,
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction [Deck ❑Porch DRe- Roofing DRe- Siding ❑Lower Level Finish 0 Fireplace
❑Addition DAlteration 0 Utility Connection / /�
CODE: DLR.C. DLB.C. ( isc. {� 0)e /2_ `s' ' "`�'
Type of Construction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have (umished 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 property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official ca evoke this permit for dust cause. urthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; I "; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
75 ,
Gas Fireplace Permit Fee $ TOTAL DUE $
This Applicatjt a Becomes Your Building Permit When Approved Paid Receipt No.
�/of `0 - /0, 1 Date By // /�/
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1 ildinsOfficial Date �i� /0 I fig- � �t.1c .........
This is to certify that the 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 constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate 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 Prior Lake, MN 55372
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This drawing is neither a legally recorded map nor a survey and is not Map Scale N
intended to be used as one. This drawing is a compilation of records,
information, and data located in various city, county, and state offices, and 1 inch = 22 feet
other sources affecting the area shown, and is to be used for reference W E
purposes only. Scott County is not responsible for any inaccuracies herein
contained. If discrepancies are found, please contact the Scott County Map Date t' / ► /7✓V
Surveyors office. 10/18/2012 S