HomeMy WebLinkAboutBuilding Permit 13. 0865 J
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o � PR/ CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, A -X TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
u 4- x AND UTILITY CONNECTION PERMIT
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2 ring: cita PERMIT NO. O. WI.
3 Yelinw Applicant
(Please type or print and sign at bottom)
ADDRESS 1 13 ZONING (office use)
S ! \ Ru • � V �--•.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
( ‘\, , ( - 4 V \ ■.)(-- L (Phone) - q9(0-1909
(Address) C S `, -e
BUILDER I (' �
(Company Name) SU.�� / (Phone) � `I I --DtcY 0(J8
(Contact Name) s+ ` ( Phone) E GA)
(Address) lc ZO cot, -A "C, l l w- s+ 1 �� 11.e _ 1 1 t M 1� ss 1 1
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TYPE OF WORK ❑ New Construction ['Deck ❑ ❑Porch ❑Re•Roofing DRe-Siding DLower Level Finish ❑ Fireplace
DAddition DAlteration ❑Utility Connection r ,�
CODE: ❑I.R.C. ❑I.B.C. n ❑Misc. VI VI t I n w �v ak5s (-1-37,r) (-1-37,r) Type of Construction: I II III IV V A B ` �C1 D • dol ' i �I J� --
Occupancy Group: A 13 E F HI MR S U ,,•
(excluding land) , 7
Division: 1 2 3 4 5
1 hereby certify that I have hirnished 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— ennoned property an• r 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
ufftci can revoke this pe cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform n • •d fns cctions.
X, . . ii..' - ..' - 4.s 1C 9/0
Signature Contractor's License No. D to
Permit Valuation Park Support Fee # 5
Permit Fee $ ~ SAC # $
-
Plan Check Fee 5 Water Meter Size 5/8 "; 1 "; 5
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 $ r
Gas Fireplace Permit Fee $ TOTAL DUE .s $ 77. 7r'
This Application $domes Your Building Permit When Approved Paid 7 1. 7 Recei I t y,L , . 1.5
11 Nf/ - - 2.3 Date B S!
13ui ∎ ( Ottieial 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 consttutcs a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
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
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