HomeMy WebLinkAboutBuilding Permit 15. 0758 1
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of re�op CITY OF PRIOR LAKE BUILDING PERMIT,
a e TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Date Recd
AND UTILITY CONNECTION PERMIT
7. G, l�
4•ArNBset•
1. Wh
Please 2 Pink ite File City PERMIT NO. �,�, 07 ,
e or Tint and Si: at bottom) s Yellow Applicant
ADDRESS
ib ,/'fax- �A yZ;• t� ZONING(office use)
LEGAL ESCRIPTION(office use only) : l S�
Z
LOT
BLOCK ADDITION /3117444/04,..)/ & -
PID p� 5 ,- �, 0/ v
OWNER
•
(Name) a Ko V I
(Address) • (Phone) 3���� ,y��
• I K--�
P
BUILDER •
(Company Name) K .. x 22
•_. . J (Phone) / 303—g
(Contact Name) i
(Address) i._ � t i , _ (Phone)
1
TYPE OF WORK ❑New Construction
['Deck ❑PorchRe-Roofing ❑Re-Siding [Rower Level Finish ❑Fireplace
❑Addition ['Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C.
0 Misc.
Type of Construction: I II III IV V A B
Occupancy Group: A B E PROJECT COST/VALUE Ob
F H I M R S U $ r--
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
Iabove-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 building
official can revoke this permit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform neede.rasp coons.
'�� ature 6
Contractor's License No.
Permit Valuation Date
Park Support Fee # $
Permit Fee
SAC # $
Plan Check Fee
Water Meter Size 5/8"; 1"; $
_ Pressure Reducer $
11111111111111111MPenalty ® I •
Sewer/Water Connection Fee # $
Plumbing Permit Fee 1111111111111 _
ater Tower Fee # $
Mechanical Permit Fee
Sewer&Water Permit Fee1111111111111.1 Builder's Deposit $
Other $
Gas Fireplace Permit Fee 111111111111111.0
TOTAL DUE IMIIIVARIII
This Application Becomes Your Building permit When Approved 741
EIidlanfiramiRecei.t No.
Date ��f�Y�
B �► -
• iiBuildins Official7 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 Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued proceed as requested. This document
Planning Director
Date
24 hour notice for all inspections(952)447-9850 Special Conditions,if any
4646 Dakota Street Prior Lake,MN 55372