HomeMy WebLinkAboutBuilding Permit 14. 0942 3 ❑ ❑ i C) 13d0000 -0 0 a NS2
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et, TEMPCITYOFPRIORILLAKE,BUILDINGPERMIT, Date Rec LORARY CERTIFICATE OF ZONING COMPLIANCE �-
AND CONNECTION PERMIT /f.
41kNEsolt. I. White File
32 Pink
Yellow City PERMIT NO. ]/J J `gqf _
3 PinApplicant <
(Please type or print and sign at bottom) /
ADDRESS
ZONING(office use)
I`i 5 91- G 1-e i.da,le. Pk e. i 5 a R.i S
-----]
LEGAL DESCRIPTION(office use only)
LOT 3 BLOCK 3 ADDITION a k i.)2) ) 44 1 xv A (Aid PID 075-- /34-O/q-a
OWNER
(Name) �ah,n1Le. Ca-() se(0nO�U 7
(Phone) -/v d- gJ�,pQ'
(Address)
BUILDER t
(Company Name)
710.\'e--�-L)C K�Y� See r—� (Phone) I-Call,Li-l/O '
(Contact Name) c ( G YU L951- p'Z p(4-LI6 la (Phone)
(Address) )9'a 0 ` C C :Rd "C 't C U•e S 4- i oA titrAt, S 5113
TYPE OF WORK ❑New Construction DDeck ❑Porch ❑Re-Roofing ❑Re-Siding
❑Addition DAlterationDUtility g ❑Lower Level Finish ❑Fireplace
Connection k0.CQ 5' (.,A1r�SCAA'S i4 a-A i 4.01113
CODE: ❑I.R.C. ❑I.B.C. 0 Misc. OFCANiiip
Type of Construction: I II III IV V A Bp ° 2.
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ D' (e2(0
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-men oned 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 evoke this permit f,, ,t cause Furthermore,I hereby agree that the city official or a designeemay enter upon the property to perform needed nspections.
x , /C'bJ
A C /V_' 13 983 1
Signature
Contractor's License No. ate
Permit Valuation Park Support Fee ## $
Permit Fee $ t JJ SAC #p $
Plan Check Fee
$ Lile- Water Meter Size 5/8"; 1"; $
State Surcharge $
Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ i Water Tower Fee ## $
Mechanical Permit Fee $ �l/f t Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 4°7Ce
/, A/ it
This Application Becomes Your Building Permit When Approved • t Receipt No. i e ter
Date
l/ �, By
3 ....,
Building Official Date q
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