HomeMy WebLinkAboutBuilding Permit 15. 0577 'JFr1
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, O1 "I°4•0CITY OF PRIOR LAKE BUILDING PERMIT, CIDate Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
��hNEti��� I. White File
i. Pinkcity PERMIT NO. is _05-++
(Please type or print and sign at bottom) 3 Yellow Applicant
ADDRESS ZONING(office use)
54:69 Ca.cd;nal ;d8_e \I-a;\ SL p015
LEGAL DESCRIPTION(office use only)
LOT q BLOCK ADDITION Al 0 ♦• •ID i —
OWNER ,�
(Name) 11 06 TO(Ow fN.-_ (Phone) 95 9 - 0o�1O- -1 a�O
(Address) I
1 BUILDER
(Company Name) r 'U..DO ArCt-C f ir- (Phone)
)
(Contact Name) ' {"JC ) — (05 I - loLI'9(O$8 (Phone)
(Address) 19 0aU C()• . `'Ct. CA3. 'gin Se.V1Ike t V1r\t 5 S 113
TYPE OF WORK 0 New Construction ❑Deck ❑Porch DRe-Roofing DRe-Siding ❑Lower Level Finish 0 Fireplace
❑Addition ['Alteration ❑Utility Connection r (�
CODE: DI.R.C. DI.B.C. D Misc �--rp\QG� LI (AJ1(\GLOWS w)i
Type of Construction: I II III IV V AB r S t •
Occupancy Group: ABE F HI MR SU
Pcl'
R JECT C `�YALUE ,V �"� �98
Division: 1 2 3 4 5 (excluding land)
I hereby certify tha 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-mentioned p•perry and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. 1 am aware that the building
official can revok• is permit for just ca . . Furthermore,1 hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X = do 13O, 83 o?S 3—(iv .0 IS—
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ 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 $
^." ..
This Application Becomes Your Building Permit When Approved p � lC v( Receipt No. 6
Dat Le � • � By
k .2z /
Building Official Date
This into 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