HomeMy WebLinkAboutBuilding Permit 14. 0449 Vr J H
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0.frfPitCITY OF PRIOR LAKE BUILDING PERMIT, �— Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT ZA Z. ��
44NEsoit• i White File
2PERMIT NO.
1 l L! �
i Cay Yellow ApplicantApplicante /t
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
Sy e C(.4-tO( C6,C., 7I-/ Se R/S.2)
i
LEGAL DESCRIPTION(office use only)
L0141 BLOCK ADDITI y AA-- PID ,.�3---aa7-, /ft-a
OWNER ('
(Name) -�` ''� J ci�.x �,t2 (Phone) 6/Z- 939-/ 7r
(Address) .SY $'0• C(/.r„aey ))^ I $ A6_, A ,IAA .c-3---a?Z,
1
BUILDER /�
(Company Name)/{ ��Or P^e— ??6,13 o'- go.„„"-...42-1 (Phone) CS-2 , Z/2. , 1,S ..S—
(Contact Name) rr - kit'`S�..._ /� n(Phone)
(Address) 3/(9 C., "�'4r L.7, De— J 1U?l .`q`b J5,, M' ' l3 /
TYPE OF WORK 0 New Construction ['Deck ❑Porch :e-Roofing ['Re-Siding ['Lower Level Finish 0 Fireplace
['Addition ❑Alteration ❑Utility Connection
CODE: DI.R.C. DI.B.C. 0 Misc
Type of Construction: I II III IV V A B PROJECT COST/VALUE $ reet0. Co
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and concct I also ccitify that I am the owner or authorized agent for the
above-mentioned pros 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 revok,..1 et ma for just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to pei form needed inspections
Xl3G sal es-
Signature Contractor's License No Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ �j '11 Water Meter Size 5/8"; 1", $
State Surcharge $ ✓ ,.... ...,._,../41/'1 Pressure Reducer $
Penalty $ lq
eIS Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other
: 797c
Gas Fireplace Permit Fee $ TOTAL DUE iir
This Application Becomes Yo :uilding Permit When Approved • l -4.�1 �� Recei.t No ([[
'#' e / ,4
.s-- -----
6 A- (.(7 . 2.. . I ---.' D. e / ` - By
Building ficial Date
This is to certify that the request in the above application and accompanying documents is in accoidance with the City Zoning Ordinance and may pioceed as requested I us document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence Before occupancy,a Ceitificate 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