HomeMy WebLinkAboutBuilding Permit 12. 1398. VOIDED O1 rxro�
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Memo
Date: Wednesday, March 20, 2013
To: Janet Ringberg
From: Lynda Allen
Subject: Building Permit #12 -1398
16697 Anna Trail S.E.
The memo authorizes a partial return of the building permit fee for permit #12- 01398. The
contractor informed us that the job has been cancelled.
Permit Refund Amount = $37.38 ($74.75 divided by 2)
Please make the check payable to:
Custom Remodelers, Inc.
474 Apollo Drive
Lino Lakes, Minnesota 55014
Thank you.
J ZL
• ,iS.
Building Services Assistant
Phone 952.447.9800 / Fax 952.447.4245 / www.cityofpriorlake.com
' I CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" • 1, 'I' AND UTILITY CONNECTION PERMIT
*A /ES°
1. White File
2. Pints city PERMIT NO /1. _ /
(Please type or print and sign at bottom) 3. Yellow Applicant / (/
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ADDRESS ZONING (office use)
I11Ce 6 17 Q- A, —rh f,
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
4 400.:// p0
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5 .
(Name) bV Oval ick, ( Phone ) q - 33 / 2 / 3
(Address) `Ws g 7 afzimt, 2 SE Pricit L.cda /21t `js37c2
BUILDER n � , /' / r
(Company Name) C_,Lap l /l od hk ' �'! /Y 1C , (Phone) Li,� / 4 ;
(Contact Name) (Add WC' I)l) Al (Phone)
(Address) 147 q � J C7l /Q. i Ji . 4,- IC ep� ,& l 571 /V
TYPE OF WORK ❑ New Construction ['Deck ❑Porch ❑Re- Roofing gRe- Sidin ❑Lower Level Finish ❑ Fireplace
DAddition DAlteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I MR S U PROJECT COST /VALUE $ * 7/ 5 - 0 2- CIO
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished 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 can revoke this pemrit for 'ust cause. Furthermore, I hereby agree that the city official � or a designee may enter upon property to perform needed inspections.
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X / t ( i j
� �/ V / 7 K 1/_/ 9 ,/ 2
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 $
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 $
This Application Becomes Your Building Permit When Approved Paid 7 7, Receipt o , 7Z n / 9
Date / f /L. By („ ^ ,om
Building Official Date
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 S.E., Prior Lake, Minnesota 55372