HomeMy WebLinkAboutBuilding Permit 13. 0256 (Re-roof) o
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// CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
(/ TEMPORARY CER'1'IFICATE OF ZONING COMPLIANCE
( AND UTILITY CONNECTION PERMIT ICI —{� � rl
r AW E S
1 _J
1 White File I
2 . > city PERMIT NO. ,�,j' 7
S6
(Please type or print and sign at bottom)
3. Yellow Applicant
ADDRESS
ZONING (office use)
, i 4 Ynrr, NE. Prior L'A\Le, mN r- 3
LEGAL DESCRIPTION (office use only)
OT BLOCK ADDITION PID
(Phone) 8 1 °)
(Address) 1+d 14 .. h 1 u Ln NE io 1( 0,4- J N c) -
... 1 9
B Company Name) � K t_e .
(Contact Name) t _ �� ,� L � ' (Phone) lQ —( (� u
/-11(4 � AAA-t, -t, ludy ( Q�customremodelersinc.com
(Address)
A.A mN
TYPE OF WORK 0 New Construction ['Deck ❑Porch e-Roofing ['Alteration 8 ['Re- Siding ['Lower Level Finish ❑Fireplace
['Utility Conne -ion
CODE: QLB.C. ❑LB.C. D Misc.
Type of Cw s:ruction: I II III IV V A B !
Occupancy Group: A B E F HI MR S U PROJECT COST/VALUE $ I 1, yy
Division: 1 2 3 4 5 °�.� J
I hereby : that I have furnished information -.n 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-men . one ...roperty and that all oonstru.. .n will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official .. revoke this : • rmit for'ust cause. F, . erm. e, I here. agree that the city official or a designee may Y enter upon the Property to perform needed inspections.
X ; 111% e,
C. j iii? ?,
/- ignature �� J
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 $ 7X7_6_
This Application Becomes Your Building Permit When Approved Paid / ��
�/ 1 Receipt No. j p,33
Date V4Zi.j By f
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
, t646 Dakota Street S.E., Prior Lake, Minnesota 55372