HomeMy WebLinkAboutBuilding Permit 15-0038 10 0 . n OtADOoa 13 0 > Ell
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CPRlp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /
,....„)
AND UTILITY CONNECTION PERMIT / 1`'�
tvi
NES���
I. White t=ile PERMIT NO. ' ^
3 PinklfCity /r `�
3 Yellow Applicant I�J`- e/
(Please type or print and sign at bottom)
ADDRESS /q/ /..EcAs / „ n c, cje ix . _x Lan j4,10... 4 ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER COI
(Name) �) (Phone) O`--933 " 97L/ô
(Address) cctvt _ (A.)' 61,4010-e....
BUILDER '� e ,
(Company Name) _� ' Ai ,► 0 f (Phone) 70`' / � C,l7
(Contact Name) `( L 1 •-12-{'/ y (Phone) ,f pa-
,..
(Address)
a-
(Address) OM c.,. .. is i S Cl/, 9/0
7
TYPE OF WORK 0 New Construction ['Deck ❑Porch e-Roofing ['Lower Level Finish 0 Fireplace
❑Addition ['Alteration ['Utility Conn ction
CODE: ❑I.R.C. ❑I.B.C. ❑Misc.
i C.�
Type of Construction: I II III IV V A B PROJECT COST/VALUE $ l coo 3
Occupancy Group: A B E F HI MR SU /
(excluding land)
Division: 1 2 3 4 5
I hereby certify thatave 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 p.r•rty and that all cons, tion will confirm to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
• official can revoke`r s permit for just ause. ermor;,1/-reby agree that the city offic• or a designee may enter upon the property to perform needed r spectio .
X i. z'./ t-L diAlli - tea_ fa 'Al
/ / Signa e Contractor s License No. •ate
Permit Valuations/ Park Support Fee # $
Permit Fee $
7.(--- ` -• SAC # $
Plan Check Fee $ // Water Meter Size 5/8"; 1"; $
State Surcharge $ /W 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 $ i 7
This Application Becomes Your Building Permit When Approved Paid 75 Receipt No. X57
Date !lL f—/•5 By /'1i(.IJ--
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. Th:s document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupa'icy 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