HomeMy WebLinkAboutBuilding Permit 11. 0791 J
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of PRI CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY C ERTIFICATE OF ZONING COMPLIANCE
A ND UTILITY CONNECTION PERMIT
8- X7 -1
U (i
I. white File PERMIT NO .
, A'NESo , P 2. Pink City // �/ f/� Yellow Applicant i (Please type or print and sign at bottom)
ADDRESS ZO G (office use)
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1
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 25. / I E3 , 60 S. d
OWNER 6 L! PI D ( ! � (
(Name) � (Phone)
(Address)
(Company Name) fl l 4Q W 14 L-0 a i- - (Phone) Co 1 36 q .6 (Comp
(Contact Name) -D Eedv t 6 P1 . / (Phone) 4 . Z75 6
(Address) �g 77 ! `Jy Sr V xCV
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TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
['Addition ❑Alteration ['Utility Conn tion
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II HI IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
1 hereby cert tha have hi .h . inf : tion on this ap., at .n which is to the best of my knowledge true and correct. I also certify that I am the owne or authorized agent for the
above -ment e..ro• rty ' +t all auction will . ./ to all existing state and local laws and will proceed in accordance with submitted plan am aware that the building
official ca vo - is p / f ' i t .+ .e urt e •■ ; eby agree that the city official or a desi en e property to perform nee s ctionsz ---�
X
/Si -0 •re o tractor's Li ense 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 $ 7 g 7-5--
This Application Becomes Your Building Permit When Approved Paid 7 f,7J eipt No. 6.g...57 Date 8. .17,1 /
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 Prior Lake, MN 55372