HomeMy WebLinkAboutBuilding Permit 13. 1074 i ce'
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PR ;O CITY OF PRIOR LAKE 13UILDING PERMIT, Date Rec
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( ` %'r r TEM CERTIFICATE OF ZONING COMPLIANCE
.; M AND UTILITY CONNECTION PERMIT
� SU I. Whig File [ ERMIl NO . 3 _ / •
:. Pink City /
3 Yellow Appikeoa
(Please type or print and in at bottom)
ADDRESS
riENING ((Accuse) 1
53 Fa L a, too es liar/ 57 c • 1 1
LEGAL DESCRIPTION (orrice use only) (�
LOT BLOCK ADDITION PID
(Name) /2,7 it' `P G !`L� t�e✓ W (Phone) 9 V i5 T29
Qom"
(Address) ' + F A10.7 -A s' b. i
BUILDER
(Company Name) ,�aeT SYVJ Q, (phone) 763- Va/ - /Vg_____
(Contact Name)
4. /A J (Phone) 763 — y -/
(Address) Q kd o . A t . .i../Z. Ai 30
TYPE OF WORK ❑ New Construction ['Dyck ❑Porch JaRc•Rooting ❑Re•Siding ELower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
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CODE: ❑ '
I.R.C. ❑1.B.C. ❑ Misc �+—/
Type of Construction: I 17 QI IV V AR PROJECT COST /VALUE S 13 3
Occupancy Group: A B E F HI M R S U
(excluding land) l J
Division: 1 2 3 4 5
1 hereby certify that 1 have htrnished inter anon on this application which is to the best of my knowledge nut and correct I also certify tent I ant the owner or authorized agent fur the
.Ibnve.menuoned property and ut;u all . .untcrton will conform In all existing state and incal laws and will proceed in ncciudanae with submitted plans 1 am aware that the budding
official can revoke this permi or jus ac. . trivia, l hereby agree than the city Mficial tar a designee may enter upon the pl »petty iO peifOrm needed ins ectiuns.
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Signature Contractor's Liccnx Nu. Date
Permit Valuation Park Support Fee 0 .
Permit Fcc S
SAC # $
Plan Check Fee $ Water Meter Size 5/8"; I "; — $
State Surcharge 3 Pressure Reducer S - -1
Penalty a Sewer /Wat�1 A Conne&tion Fcc # S
_ 1
Plumbing Permit Fee I .S Water Tower Fee # S
r Mechanical Permit Fee C .S Builder Deposit $
Sewer & Water Permit Fee 3 Other $
r Ci i Fireplace Permit Fee $ I TOTAL DUE — S � �'
19 7
This — Application Becomes Your building Permit When Approved Paid Sir � y
s cei t ]f � /aU
Date
Hsnitling Orticl:al ,— Uale
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'fhn is ;u certify at uss nn,cst n the maw,' : ' �•�
fy I n•vtic.nwn and accumpanymp documents is in accordance with the City Zoning Ordinance and may proceed as rcnuestcd. this document
when signed by the City Pta..ner constitutes a tettlput. Certilicate of Zoning compliance and allows construction to commence. Heroic occupancy, a Cc lieue tat Occupancy must be
ttsucd
_ _ Plunning Director note '. Spec al Conditions. i1' any
T 24 hour nonce for all inspections (952) 447.9Mi11, lax (752) 4474245
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