HomeMy WebLinkAboutBuilding Permit 13. 0832 CD JQ
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4 PR/0 4. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
A'
TEMPORARY k
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
n AND UTILITY CONNECTION PERMIT 7 2"I 13
414tNE6Olt. I white rile PERMIT NO. 3 pink city s h 3z
3
3 Yellow Applicant `� -
(Please type or print and sign at bottom)
ADDRESS ZONING(o Ic Te)
111/
Sy i l( 14 ,2 r) Alt 1"/ r lbr�
LEGAL DESCRIPTION(office use only) �/
LOT y BLOCK ADDITION �I( i...S .l .AA 4& PIDZc. . 0 2-C.
OWNER
(Name) ,"-e t..� A+,t -"-`_ (Phone) r1 4,2- 2 i'2"TPliL Cr
(Address) 3'? 7 S(.i.,-f/ Vic.,tr'/ C.. Ili_ AAA/ P" Z. .75-73 7 ..__-
BUILDER
(Company Name) /G'.l t (& 4 Jr4 Gt w'61 t y 4?U1/1.e S (Phone) 9 s2 tt f1-= �7
(Contact Name) ,/tip * JQk 4o% -a / /
r -(P-hone) 6 -0112- 7�(�C�
(Address) /76415- .7-...t...-,-,'A-e....- `<u.� e /57 Zn@I e,f p
TYPE OF W RK 0 New Construction *Deck ❑Porch ❑Re-Roofing ORe-Siding ❑Lower Level Finish 0 Fireplace
❑Addition ❑Altera io DUtility Connection
CODE: C. ❑LB.C,
0 Misc.
Type of onstntctio • I II III IV V A B c'r Qa-47-
Occupant
Occupant y Group: A B E F H I M R S U PROJECT COST/VALUE $
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 tnie and correct. I also certify that I am the owner or authorized agent kr the
above-mentioned property and that all construction ' onform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building i.
official can revoke this permit for just cause Fp rmo .I hereby agree that the city official or a de ce may enter upon t e ro erty to perform needed Inspections.
X .e—` C63/x ' 7- s-,/3
Signature Contractor's License No. Date
Permit Valuation 5'Ora0. Ud Park Support Fee tl $
Permit Fee $ LU 3 SAC # $
Plan Check Fee $ /‘ 9 �- Water Meter Size 5/8"; 1"; $
State Surcharge $ , . �r� 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 .7 3 $ /67474
7/. Q,
This Application Becomes Your Building Permit When Approved Paid / 77 67 R. S. �`C> Cf/
ill__0
_Date (/ Z /3
I ding Official Date
d
This is to cert' accompanymg documents is in Cty Zoning Ordinance and may proceed as requested. This document
when signs e , •, o commence. Before occupancy,a Certificate of Occupancy must be
issued Special Conditions,if any
23 tour notice for all inspections(952)44752)447-4245
4646 Dakota Street Prior Lake,MN 55372
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