HomeMy WebLinkAboutBuilding Permit #13-159 o � eR� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT
v �,
~�HAlESO�h I. Whi�e File
2. Pink c,� PERMIT NO. 13 .`��
l Yellow Applitant
Pltase or rint and si at bottom
ADDRESS ZONING (o�t'ice use>
� �� 14"� � .� �s�
LEGAL DESCRIPTION (ot3�ice use only)
LOT BLOCK ADDITION PID
OWNER �'��� Y / , , ' �
(Name) V�J� SBYI (Phone) ��
(Address) �i�"�.� ��� �
BUII.,DER �� ,�� e ,, 6e,,� Phone 7�� ��� ����
(Company Name) ( )
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Consauction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteradon ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B pROJECT COSTIVALUE S
Occupancy Group: A B E F H I M R S U (excluding land)
Divisiorn: 1 Z 3 4 3
I herrby certify that i have fumished information un this application whieh is to the best of my knowicdge true and correct. t also cerrify that I am the owncr or authonzed agent for the
abovc-menuoned property and at alt cunstruction wiii conform to atl existing state and tocal laws and will proceed in accordance with submitted plans. I am awam that the buildu�g
uffici can r ke shis peim r just cause Furthe�more, I hereby agree that the ciry officiai or a designee may enter upon the property to perForm necded mspections.
��
�L�� u ? �l�l C� 2 � 2� /.3
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Siz 5/8"� i"; $ g Q�
State Surcharge $ Pressure Reducer $ b
.
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ . DO
1'his Apptication Becomes Your Building Permit Whrn Approved pald ReCei t NO.
� Zs �j� Date S. B
Buildin � OtTicial Dnte
This �s to certify that the requcst in the above appiicauon and accumpanying documents is in accordance with ihe City Z.�>ning Ordinanee and may proceed a+ requ�secd. This document
when signrd by the Ciry Planner const�tucrs a tempurary Certificace of Zonin� compliance and allows canstructiun to commence. &fore �xcupancy, a CernC'icate of Occupancy must bc
issucd.
Planning Director Date Special Conditions, if any
24 hour noticc for all inspections (952) 447-98SQ, fax (9S2) 447-424,5
464b Dakota Street Prior Lake, MN 55372
� _
�