HomeMy WebLinkAboutBuilding Permit #11-0522 oF PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / Z Z,!�
� � AND UTILITY CONNECTION PERMIT �Q
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���'NES��� �� �� �. Wh,�e File PERMIT NO. /�— Z
� 2. Pink City
3 Yellow Applican�
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ADDRESS ZONING (ottice use)
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LEGAL DESCRIPTION (ofiice use only)
LOT BLOCK ADDITION PID
OWNER -�- '
(Name) � ('i l�!'I f�� T �fa �'!
(Phone)
(Address)
BUII.,DER
(Company Name) 1 �f (Phone) � �� — 7gs : ��
(Contact Name) ��/ �i��?' (Phone)
(Address) Z�O�j �°�/- �/ �,�r � .e �'
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e-Roofin
g ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Conn tio
CODE: ❑I.R.C. ❑I.B.C. O Misc.
Type of Conshuction: I II III N V A B PROJECT COST/VALiTE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have fumished information on this application which is to the best of my knowlcdge true and coRect. I also certify that I am the owncr or author�zed agcnt for the
above-menn d r d that all construction will conform to alt existing state and local taws and will proceed in accordance with submitted plans. I am aware that the buildmg
official ca revo e this er just u Furth more, I hereby agree that the ciry official or a designee may enrer upon the property ro perform necded mspectlons.
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Signature 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 $ � 7�
This Application Becomes Your Building Permit When Approved Paid �� R el t NO. J I
Date � � /
Buildine Utlicial Date
This �s to certify that thc requcst in the above applicahon and accompanying documents is in accordance with thc Ciry Zoning Ordinance and may proceeA u requcstcd. Th�s document
when signrd by the Ciry Planner conshtutes a temporary Certificate of Zoning compliance and allows construction ro commence. Before occupancy, a Ccitdicate uf Occupancy must be
issucd
Planning Director Date Special Conditions, if any
24 hour noticc for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Sueet Prior Lake, MN 55372