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HomeMy WebLinkAboutBuilding Permit 12. 1327 VOID �� PR I OR �,� �, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / J 2._ ( AND UTILITY CONNECTION PERMIT c . 4:1. .... k NEs o 1. White File . P PERMI NO l - 3ello City (Please type or print and sign at bottom) 3. Yellow Applicant ADDRESS 5 L j 1 s ,,..n, MO i Cier(/1 G.. 3f/20 1C— L LS ZONING (office use) 5500 C ©Trepnv).00,P (a nt S 1 co LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID 2-S Z fCe . CO ( 1. OWNER (Name) � 5 n (; G L.L. (L.t,' 1 C C,S (Phone) 9 2 ^ 5.;8' - Z 2 a Z (Address) 1 2 � C7 47 nC_C C:( ri . rj. Co i r-N,a) ` 0 -, i S'Sti 3F BUILDER (Company Name) (2,4 L1 Gl r\LC 6c, n5 v c.-r• er>r, (Phone) R ^ '7 -- S2 2,..c, (Contact Name) 11Ylb1 ....k7 }-1 (' s r. (Phone) (Address) 5 $ 0 L,1 tmC_D& -r1 02 l U 4I- y .A G/•°.) N .✓lr1 r Ste L} 33L. TYPE OF WORK ❑ New Construction ❑Deck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ['Addition jgedteration ['Utility Connection CODE: ❑I.R.C. I.B.C. ❑ Misc: Type of Construction: I jj? III IV V A Occupancy Group: A. E E F II I M R S U PROJECT COST /VALUE $ 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 ok�mi�jus se. rthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X 10 •31^ 17— Signature Contractor's License No. Date Permit Valuation 1 0000 _ Park Support Fee # $ Permit Fee $ ; Q I sp SAC # $ Plan Check Fee $ 1 . 1 , Water Meter Size 5/8"; 1 "; $ State Surcharge $ 5 - 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 _ $ 320. °18 This App , a .n r . comes Your 1�uilding Permit en A 'rove Paid Date Receipt No. 1 By A. / /ha.■ It az (2- F icial aa 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; Tanner constitute a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. Vit Plannin. I. irector 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