HomeMy WebLinkAboutBuilding Permit 13. 1019 Ve J
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Reed
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 7 l3
e
AND UTILITY CONNECTION PERMIT
�sjN E 5Q �
z a. wr rc rik f PERMIT NO. /3 0 � ci ` -` / /
3. Wiwi Appham
(Please type or print and sign at bottom)
ADDRESS ZONING (office )
LI 98 2 Aiwa/ Ai m e. ' NE
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION P - 0 7 4,0 22 6
(Name) OWNER 6k )'4.1 h Q ,gL t and (Phone) q5c9 2(z)-3r eL.p
(Address) Li d 8- 3 fl 00/ - Ma. ie St. NE . Pk10 K Cot K.6 nit Al
BUILDER
(Company Name)eI1RL I A, E K 7E/ J O R.S (Phone) q5a 83 i - 0 2 0
(Contact Name) RY0 Ash 1 h / (Phone)
..
(Address) '1(1 I LI 0 V I Kt ►J61 fsLs e- . S i D5 £..bi iv A AA /\.
TYPE OF WORK 0 New Construction QDeck OPorch )16- Roofing QRe-Siding QLowcr Level Finish 0 Fireplace
QAddition DAheration ['Utility Connection
CODE: I.R.C. D.B.C. Q Mist.
Type of Construction: I II III P/ V A B Q _i
Occupancy Group: A B E .F II 1 M R 5 U PROJECT COST /VALUE $ l' 4` U t t 5r
Division: 1 2 3 4 5 (excluding land)
1 hereby certify that I have furnished inlvrma1iou on this application which is to the beet of my knowkdgc true and correct, 1 also certify that 1 am the Dormer Of authorized agent for the
above-mentioned property and that ail eorsouction will conform to alt existing state and local tarn and wilt proceed in accordance with submitted plans. 1 am aware that the building
official can ibis pemltt ci . Fuitherntote, l hereby agree that Meaty official or a designee may enter upon the property to perform needed
0 Signs a Contractor's License No. Date
Permit Valuation Park Support Fee # 5
Permit Fee 5 t q r ,-- J - SAC # 5
Plan Check Fee 5 Water Meter Size 5/8 "; 1 "; S
State Surcharge 5 Pressure Reducer S
•
Penalty S Sewer /Water Connection Fee # 5
Plumbing Permit Fee 5 Water Tower Fee # 5
Mechanical Permit Fee 5 Builder's Deposit S
Sewer & Water Permit Fee ' 5 Other 5
Gas Fireplace Permit Fee 5 TOTAL DUE 5
This Application Stamina Yom Building Permit When Approved Paid ( 7(-.... ��/
R pt No. � ''~�,
Date _ � 7 , a I
. 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 coastnution to commence. Before occupancy, a Certificate of Occupancy num be
issued.
Planing Director Date Special Coo:Mims, if any
24 hour notice for alt inspections (952) 447-9850, fax (952) 4474245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372