HomeMy WebLinkAboutBuilding Permit 13. 0595 5 000 n 000000 7 0 > 2 SG
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OF Pfli CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
0 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 6 /3 13
. x AND UTILITY CONNECTION PERMIT
v In
4 /NNEso'tr I. white File PERMIT NO .
2 pink City /3 ✓✓ / �1�
3 Yellow Applicant
(Plea or�rint and sign at bottom)
P .A i DDRESS) ZONING (office use)
I ? Gte. A,,,). 3E
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
R � t � G c , � t 1 G °"ASi n c ;
Name) ) (Phone)
(Address)
BUILDER //�` f 46.?-11-1°
ompany Name) (�O nc'_ G oe) �� S
ontact Nam) 0104 134e-' 134e-' � (Phone) /
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( f I3d f 4,r�nS 1'"otrk1&JtaNt N w A l�akA inAi
TYPE OF WORK 0 New Construction ❑Deck ❑Porch DRe- Roofing DRe- Siding ❑Lower Level Finish 0 Fireplace
❑Addition DAlteration ❑Utility Connection �' _
CODE: DI.R.C. D.B.C. 0 Misc. /Mil s p AA fl - C-511-117,,- /9 6/- 7646s�
Type of Construction: I II III IV V AB
/
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
(excluding land)
Division: 1 2 3 4 5
I hereby certify that I have htrnished information on this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for the
above - mentioned property and that all construction will co form to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke this rmit for just cause �trpthermo . jlereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X �/ � � s7 3i /3
g nat u re - entractor's License N . Date
Permit Valuation
...) 60b .. o b PP Park Support Fee # $
Permit Fee $ ( E(` SAC # $
Plan Check Fee $ 5`1 3 (C) Water Meter Size 5/8 "; I"; $
State Surcharge $ i 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_ /1
This Application Becomes Your Building Permit When Approved Paid f 4. /' i i R eipt No. (0 g/S U
Date £, / (J
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
�i .4 — 6.._/3 a.
i Pla 'g 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
Scott County, MN
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This drawing is neither a legally recorded map nor a survey and is not
Map Scale N
intended to be used as one. This drawing is a compilation of records,
information, and data located in various city, county, and state offices, and 1 inch = 33 feet
other sources affecting the area shown, and is to be used for reference
purposes only. Scott County is not responsible for any inaccuracies herein W E _...
contained. If discrepancies are found, please contact the Scott County Map Date
Surveyors Office.
6/13/2013 S µ; (40 .