HomeMy WebLinkAboutBuilding Permit 14. 0596 J
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of PRio CITY OF PRIOR LAKE BUILDING PERMIT, l< � Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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�INNESp�P I. White File PERMIT NO. —
2. Pink City /L: ` / .••111�
3 Yellow Applicant 77 J 111CCC......
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
I5SQ5 6rr a - I-Ca 5. E . /7/
LEGAL DESCRIPTION(office use only Y C,/
LOT BLOCK`��2� KnI IO PID �' -C)117.-6
I(AddOW(NNER — �>✓ t L�G�-ke S (Phone) 50 — 1-741-9-" 5-71D-
(Address)
ress)
BUILDER
(Company Name) ulYC32 C5lJ� � (Phone) 10 pl S�Ctog� Y408 )(Contact Name) n u l (Phone)
an
(Address) I !Q 2 V CD•�d , ,L�� LA)- -S' ?is‘12.LA'1.e` m i SS I ) r^�
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TYPE OF WORK ❑New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Le el Finish ['Fireplace
['Addition ['Alteration ['Utility1.
Utility Connection Ficf1 /+n - CAA (_&J)i hl -G/sct5/ i3
CODE: ❑I.R.C. ❑I.B.C. ❑Misc.lY` C�2�-/` )
Type of Construction: I II III IV V A B PROJECT COST/VALUE $ `4, /JVtCJ 00
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have tarnished 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- toned 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 c revoke this permit f, t cause Furthermore,I hereby agree that the city offic I or a designee may enter upon the property to perform needed inspections.
X • a 136983 /9,Iv►�J
Signature Contractor's License No. Date
Permit Valuation ' Park Support Fee # $
Permit Fee $ LI
1) SAC # $
Plan Check Fee $ li: ` �, Water Meter Size 5/8"; 1"; $
State Surcharge $ b t, v 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 $ 7q,
This Application Becomes Your Building Permit When Approved a fici„ Receipt No. ' /
ate k. By
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 construction to commence. Before occupancy,a Certificate 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 .