HomeMy WebLinkAboutBuilding Permit 13. 0755 ot... F Pi tJoCITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, TEMPORARY CERTIFICATE OF ZONING COMPLI NCE r � /5 `` AND UTILITY CONNECTION PERMIT / '
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(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 10 0 b ( 0
OWNER \ , (� 9
(Name) k (tfil S4 C C' C L' 15 t S / (Phone) 1-� ` S v ,V2
(Address)
BUILD . : -_
• • mpany Name) d t RIZ- F ' Y Phon ) (0 5 's'L2 c9f / 2.
d c 4 kr■it=- A)W (Phone)
.. res.!) [ '91'1 1 -6 5 t /" &7 ' -
TYPE OF WORK 0 New Construction ['Deck DPorch DRe- Roofing DRe- Siding ❑Lower Level Finish 0 Fireplace C)eeo(.�-
DAddition jlteration DUtility Connection '�
47906-2-40 7 �s
CODE: DI.R.C. DI.B.C. 0 Misc.
Type of Construction: I II III IV V A B 700 CO
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 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 ropciry a . 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 can rev this per /for lust cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
IX 41 44144 C -1
ignature Contractor's License No. Date
Permit Valuation '-7 0 o , 0 0 Park Support Fee # $
Permit Fee $ 3 I. 5-0 SAC # $
Plan Check Fee $ 2-0 ¢8 Water Meter Size 5,(8 1"; $
State Surcharge $ , 5-0 Pressure Reducer $
Penalty $ Sewer /Water Cs • ion Fee. # $
Plumbing Permit Fee $ Water Tower ;e r' � # $
Mechanical Permit Fee $ Builder's Desit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 5Z _ 7 e
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i Ap licati L 7 � Becomes Your Building Permit When Approved
Paid z , Re e {it NO.
Date '7_ _ (s " <7
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. iilding Official vi e
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 issued
commence. Before occupancy, a Certificate Occ panty must be
�, oQ !/ Uter, 2 + ` !( /'/ /1 /-�// Xiee-X „ /�
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