HomeMy WebLinkAboutBuilding Permit 12. 0309 VOID 0 CITY PR-1.
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OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE I f) Z3, / 2
PERMIT NO
.. AND UTILITY CONNECTION PERMIT
V I r j
441vESO'sr I White File Pink City 401:9/
2 3 A
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/ p7 L.A 4 n.Art-C 2._✓1 l /
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID z5 .3/4 ,. 035 O
OWNER
(Name) X20/3 //11 S /-r (Phone) tr.2- — 4 /s 2- " 2- 37
(Address) / 7 LA u /1 4:. ,_ 4#0
BUILDER V
Name own/ e / L- 4 0 v (Phone)
(Company ) `V N
(Contact Name) /5 • (Phone)
(Address) `11/ •
TYPE OF WORK ❑ New Construction ['Deck Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
['Addition ['Alteration ['Utility Connection
CODE: t I.R.C. ❑I.B.C. rfe sc. 6 gsaC
Type of Construction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U
(excluding land)
Division: 1 2 3 4 5
I hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authorized agent for the
above - mentioned pro • Ty and t at all cons ion 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 revok erm just umber e, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X , /Z3 //
- Signature Contractor's License No. Date
Permit Valuation r50,6,0- Park Support Fee # $
Permit Fee ,--- $ SAC # $
Plan Check Fee / 2f_ $ T Water Meter Size 5/8 "; I"; $
State Surcharge C7--'N° $ r 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 / > 1 S. C
This . plication :e Imes Your Building Permit n Appr ved Paid // Receipt No.
Date By
' ,] hi / `' i (Z
Bui fic . Date
This is to ce that th' - equcst in the above application and accompanying doe ents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sign ■ y th_ Ci'1 'la ner cdnstitutcs a temporary Certificate of Zoning c mplianc and allows construction to commence. Before occupancy, a Certificate of Occupancy must he
issued I ' ) i
at z
e Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 - 4245
4646 Dakota Street Prior Lake, MN 55372
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