HomeMy WebLinkAboutBuilding Permit 15. 0277 0 n O 0000 o > E0
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CITY OF PRIOR LAKE BUILDING PERMIT v
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c TEMPORARY CERTIFICATE OF ZONING COMPLIA
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AND UTILITY CONNECTION PERMIT NCE
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I. White File
Please 2. Pink city PERMIT NO. l s. Z-7
( .e or t rint and si:n at bottom) 3 Yellow Applicant
ADDRESS `� R
L! !/ Y ` 05 ,0061 c !' R ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION
OWNER / PID
(Name) �� T t o /Q 1
Y y 7 (Phone) �' / 2 f 3 0 t , r0 3
(Address) , 4 s ' 6 d f•i Q Z ef. ,L Wu
BUILDER THD At-Home Service, Inc,
(Company Name)_ 2690 Cumberland Pkwy, Ste 300 /
(Contact Name) Atlanta, GA 30339-3913 (Phone) 9 Sa l 39s • Goy 7
(Address) Lie#CR268257 Ph. 763/542-8826 (Phone) 0 di
TYPE OF WORK
Construction eratio❑n ['UtDeck [] rch Ce ty Conner ione Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace
CODE: DI.R.C. �
❑I.B.C. D Misc.
Type of Construction: I II III IV
Occupancy Group: A B V A B '
Division: E F H I M R S U PROJECT COST/VALUE $ "_l__ _'‘__1,5
1 2 3 4 5 (excluding land)
I hereby certify that I have fitrnished information on this application which is to the best of my knowledge true and conece: I also certify that I am the owner t»authorized agent for the
above-mentioned 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 buildm
official can revoke this permit for just cause. Fur hermo ,I hereby agree that the city official ora designee may enter upon the property to perform needed msp• tions.
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CR ac % asp
Signature 3 4 j,s
Contractor's License No.
Permit Valuation Date
Permit Fee Park Support Fee #
laIIIIII.. 1111111111111.
Plan Check Fee SAC , #
lgIIIIIIIIIn Water Meter Size 5/8"; 1"; laillimi
Penalty Pressure Reducer
Plumbing Permit Fee Sewer/Water Connection Fee ##
Mechanical Permit Fee •
Water Tower Fee #
Sewer&Water Permit Fee Builder's Deposit •
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Gas Fireplace Permit Fee Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
• Paid 4I
Rece'. No.
Date ,
Building Official B
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
when signed by the City Planner constitutes a temporary Certificate of Zoningcompliance and allows construction to commence. Before occupancy,
issued. p y,a e tas requested. This document
b
P� Y,a Certificate of Occupancy must be
Planning Director
Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 Special Conditions,if any
4646 Dakota Street Prior Lake,MN 55372