HomeMy WebLinkAboutBuilding Permit 10.0804 & 10. 0805 b o z a a:1 \_ !�
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of PR CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
3 Yello w Applicant N
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
M� A' NE 5 04P � I. white File PERMIT NO .
e l City ' ^ ., T�` 0+
3 lo
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
5c2 34 L u ri . f .0 .. D1�—
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER f_jj jiff -�
(Name) Sr. PA.A- s 7"t`f'"r✓ ti J C-W (Phone) ic� ' ` ! l
(Address) S " e
BUILDER w,�t L G IN G .
(Company Name) ' _` l (Phone)
(Contact Name) •J M LU C- _ (Phone) 441 ` Z053
(Address) . 7626 4, # /i (G ct-/ /"L/'i S - a-
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re- Roofing ['Re-Siding ['Lower Level Finish ❑ Fireplace
['Addition ['Alteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. klisc. LA4 J P-i ( g-' &A r' o s.-1
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
Division: 1 2 3 4 5 (excluding land)
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 property and 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
off 'al can revoke this snit for ill use. Further ore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
_nature Contractor's License No, Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8 "0 $ 415 . '..-
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 $
Gas Fireplace Permit Fee $ TOTAL DUE $ A15.. r
This Appl n B I. es Your Building Permit Whe • Approv • d Paid 4 , Receiptt Jo.rL9' ' 7 v
` r Date / I `' (o By 1 —t 6\
AL
O
Building Ofticia 'ate
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
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10 RIA1 C e � - j / Reis/ /4) etr tarr&t. •
Planning Director Date Special anclitions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
o rR IO�P Date Rec'd
0 CITY OF PRIOR LAKE
Q SEWER AND WATER PERMIT
jNNESO
2. G
1. Green Fite PERMIT NO. r
ol d Applicant
r O�
3. Gold Applicant l
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
al034 Lv-n +4-L DP.,.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) T`. PA Li LS L (JTtkea 4.c. (Phone)
(Address) S'4",\ G
(Address) (City) (Zip Code)
k
APPLICANT/ 51Y? ec - 6 '"7
(Name) ', to i r -- /IOC (Phone) 55 T l
(Address) .. 01 6 AS
d ?4.
(Ad• ess) (City) (Zip Code)
(Contact Person) AIM. ■ IIII■ (Phone)
APPLICANT SIGNATURE 4...;.. DATE 7c /3 — /7
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches. 0
Location of any couplings from structure feet. C fLn G Oka—.
Type of sewer pipe. I=1 ABC ❑ PVC 111 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure. Lv..)6
FEE SCHEDULE
Residential sewer and water line connection $51.50 Industrial, Com'l & Multi- family ° . of 'ob cost with a $51.50 minimum
Sewer connection only $25.50 Water connection only $25.50
Estimated Cost $ Building Permit #
SEWER AND WATER PERMIT FEE $ 25.G0
STATE SURCHARGE $ .50 0
TOTAL PERMIT FEE $ 30 .00
IN
(Office Use /f I )
This .41 / t' i . 1 � es Your Build' _ ' er i t Whe Approved Paid ` ..... Receip N
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di,.Official l ate Dat t /rs By F 8 os _
'�.,__ 2- hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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