HomeMy WebLinkAboutBuilding Permit 14. 0447 PRio CITY OF PRIOR LAKE BUILDING PERMIT,
Date Rec'd
o R TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 3 6 ,l'4"
a x AND UTILITY CONNECTION PERMIT IJ /� CU
v t�
1. White File PERMIT NO. /NC
2. Pink City
��NNES��P 3 Yellow Applicant
ZONING(office use)
Please a or rint and sin at bottom) S,(o
ADDRESS /j J• /�o d. n r C e _/
ri 1
LEGAL DESCRIPTION(office use only) 2-5- j 7--. OU�,
LOT BLOCK ADDITION PID
OWNER (Phone)
(Name) 1 v '
(Address) �^ ¢ Q (�
BUILDER 1 `
(Company Name) / l , /` e (Phone) � 2 O �__
Z.
(Phone)
(Contact Name)
(Address)
TYPE OF WORK 0 New Construction lk,eC�Ut�ry Connecrch �Re-Roofing ❑
Re-Siding ❑Lower Level Finish ❑Fireplace
❑Addition ❑Alterat on
n
0 Misc.
711
CODE: ❑IDI.B.C.
Type of Construction: I II III IV V A B E F H I M A S U PROxcludiOng land $
Occupancy Group: I 2 3 4 5
Division:
upon the accordance with performubmneededplainI amiaw
conform to all existing state and local laws and will proceed
in submitted plans. I am aware that the building
I hereby certify that I have furnished information on thapplication which is to the best of my knowledge true end correct. I also certify that I am the owner or authorized agent or e
above-mentioned property and that all construction will
official c• revoke this permit for Lst use. Furthermore,I hereby agree that the city official or a designee may —
Date
dair
X Contractor's License No.
— I Signature $
Park Support Fee #
Permit Valuation 1r6 Q Q• 0 • $
Permit Fee $ 03- 111 NE11111111111111111111111111M $
$ ! 1Water Meter Size 5/8"; 1";
Plan Check Fee �5
Pressure Reducer
$
1
11111111111111
Sewer/Water Connection Fee #Water Tower Fee $
Plumbing Permit Fee 11111111111111111
Penalty # $
Builder's Deposit $
Mechanical Permit Fee11111111111111111
$
$
Sewer&Water Permit Fee Other TOTAL DUE Ar '1-Z.!�" $ /7 C
Gas Fireplace Permit FeeIIINIIIIIIIIIII 1
Rec:S•t No. --dr
lie• +on :; eine•Your�uilding Permit Whe Ap,•I ved Paid
�, L
d, :•i
This App i Date l
� r
juild`na Official rate
a as eqte of ed..OccThis document must nt
Cer
This is to certify that t•e roque int •above application and accompanying docume s is i. accordance with the City Zoning Ordinance and may proceed as requested. This
when signed by theif ti' P 'r co tallies a temporary Certificate of Zoning tom.tante nd allows construction to commence. Before occupancy,
issued. �—
�// ANIS.—
I Z Special Conditions,if any
P �IF ���11111.1111k II ate f•lammng Dtrector��-
24 hour notice for all inspections(952)447-9850.fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372