HomeMy WebLinkAboutBuilding Permit 13.0939 CD 1NZ
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OF PR�O�P CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE C
AND UTILITY CONNECTION PERMIT ,/
~r'�>resot� I White Ede PERMIT NO. (.. ,....73
7.
City .-r
3 Yellow Applicant
9
(Please type or print and sign at bottom) `//
ADDRESS
ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) 1:(.- _ L.,`,c-t 14:(-c f c (Phone) ci ) ( '5"`7 i `(
(Address) �/ 7�'C 1,,c .-f ( a t )L 1 ,',, i L
BUILDER
(Company Name)
(Phone)
(Contact Name)
(Phone)
(Address)
TYPE OF WORK 0 New Construction ❑Deck ❑Porch ['Re-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace
❑Addition ❑Alteration ❑Utility Connection 1
CODE: I:�'R.c. ❑LB.c, n. M .:" _, _ ' i,i 30 C=,AL iGASa WfAd"5
Type of •nstruction: I II III IV V A B .0 : ply-- t
Occupancy Group: ABE F HI MR SU 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 of 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
official can revoke this permit for lust cause Furthermore,I hereby agree that the city official or a designee may enter upon the piopeny to pet form needed inspections
"'—C.-- A'1.e L c-''---- ...._. :(5,',/j),-5./A -A..)
! Signature Contractor's License NoDate ate
Permit Valuation ZS-®D, — Park Support Fee # $
Permit Fee $ 1A-475. SAC # $
Plan Check Fee $ Water Meter Size 5/8", I"; $
State Surcharge $ r— 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 $
This ,,licati.n B 2/o a Your Building Permit Wh , Approv•+ Paid /
J ��� Receipt No. [l? ��
� � Date g Z By
Building°thcit late
This is to certify that t •request in the above application and accompanying documents s in accoi. nee with the City Zoning Ordinance and may proceed as requested This document
when Signe b the C y Planner constitutt?s.a temporary Certificate of Zoning compli cc and al ws construction to commence Before occupancy,a Certificate of Occupancy must be
issued
b h..!Ar . D
Special Conditions,if any
24 hour notice for all inspectio s(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372