HomeMy WebLinkAboutBuilding Permit 12. 0945 `
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Pita6 CITY OF PRIOR LAKE I UILDINC PERMIT, Date Rec' d
A. : O. , '4 %. 6T t- TEMPORA'' Y CE'', TIFICATE OF ZONING COMPLIANCE
� :' ? AND UTILITY CONNECTION PERMIT
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'NNESO -C I. White File
2 p PERMIT NO.
e City A 1 V /�_�} �/ / L
J Yellow Applicnm V �J �,
(Please type or print and sign at bottom)
ADDRESS ZONING (office usej
53 7 8 /717ie 44 w v -s1-1 --V
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) 7291---1 i 74 ,g' S (Phone) 9 SZ - Y5/O — LA
(Address) 5f1'- - "='
•
BUILDER
(Company Name) S PP-t ( r i l l c o . , • s 5.7Y2 u e i k o , . J St a d e , e . , e — 5 (Phone) 9 2 — 4 1 4 1 1 4 — 91 7
(Contact Name) I.i,.NNiS 4. -cAo) (Phone) 5 i i i- a
(Address) P O. 60y 6,(06/ P9--- _4 .- '-t SS 3 ? Z
TYPE OF WORK 0 New Construction ❑Deck DPorch e- Roofing DRe- Siding ['Lower Level Finish 0 Fireplace
❑Addition DAlteration ['Utility Conne ion 0 Misc.
CODE; D.R.C. DLB.C. PROJECT COST /VALUE $ 3/2 0.9 .J
Type of Construction: I II MTV V AB (excluding land)
Occupancy Group: A B E F HI M R S U
Division: 1 2 3 4 5 I
1 hereby certify that I have furnished information on this application which is to thc best of my knowledge true and correct. I also certify that 1 am thc owner or authorized agent for the
a. •e -m , noned property and that . uction will conform to all existing state and local laws and will proceed in accordance with submitted plans. 1 am aware that the building
o -;a1 can evoke this permit 4. filliki ore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X w _.... ec VOa /sy 8 .
Signature Contractor's License No. Date
Perinit Valuation 4• 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 $ 79, 73
This Application Becomes Your Building Permit When Approved Paid ' /- S Recei. si // // 96 1
Date !tfrZW IA I I I II I li 111 I I I B •ij AMIIIIIIIII.
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
16200 Eagle Creek Avenue Prior Lake, MN 55372