HomeMy WebLinkAboutBuilding Permit 15. 0862 f
0 PRi �P � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
A,
c �E \ PORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT g Z I /r
yiNN6tioi� 1. White File PERMIT NO. /AT
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3 pink City C!
3 Yellow Applicant '/'�J'l
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
55?/ Ante c/ ,err ve Temic' h-b, mi0 5:45-37a, pup
LEGAL DESCRIPTION(office use only)
4 z
LOT IBLOCK ADDITION 'Aloe, 4)14,1„, J &-�% /4 D 3� z,! 1 O44 Q
OWNER
(Name) ba sr 1' - (Phone) c2- 97 7/9(o
(Address)553'f bk0- Lrit)e, AO Z6/62.
BUILDER ,fin 45/-,?36 -9'‘/_q(Company Name) i& !� air,tiact 6,-2,..../0 (Phone) 45i ?3 ' 9'a/_
(Contact Name) /A( � (Phone)
(Address)o9LJ 5( rr70-27 �an/ fl S'O///C / Gtr S-6-33?
TYPE OF WORK 0 New Construction deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower 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 PROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
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I hereby certity 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
above-m ntioned property and that all construction will conform to all existing state and local laws and will proceed ino accordance with submitted plans. I am aware that the building
officia revoke this it forju t cause. Furthermore,I hereby agree that the cityofficial ora designee may enter upon the property to perform needed insppeecctionns.
X 2 adei47t907 2_,97..../5
//
Signature Contractor's License No. Date
Permit Valuation 2/Coo.C" Support F-= # $
Permit Fee $ i -75-
- SAC • # $
Plan Check Fee $ °7 •60,.4... Water er C 3) '' to . dill $ s
State Surcharge $ l 0 0 Pressu' Redu /71
-
. ---,, ' $
Penalty $ Sewer Water t in -- - - $
Plumbing Permit Fee $ Water ower ' - • • - r
.. -r `-
Mechanical Permit Fee $ Builder' 'repo t
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE
....r
This A licati Becomes Your Building Permit Wise Approv d Paid /2.,_ _(q R • 1pt NO. `v �7
Date
r ,'ild g Oftic i Dat a'
This is to certify that t c r•quest in the above application and accompanying documents i in accort nce with the City Zoning Ordinance and may proceed as requested. This document
when signed by the I nner constitutes g-temporary Certificate of Zoning compliant•and all s construction to commence. Before occupancy,a Certificate of Occupancy must be
issued. '
'anning Directo _.....,T D to Special Conditions,if any
24 hour notice for II inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372
Eti4:14.A)
U VI
1
MEMORANDUM
DATE: Wednesday, August 19, 2015
TO: Janet Ringberg
FROM: Lynda Allen
RE: Deck Permit#15.0862
5581 Amblewood Drive
The homeowner at the above referenced address has opted not to build a deck at this time.
Please refund the permit fee as follows:
Permit Fee $73.75/2 = $36.88
Plan Check Fee $47.94/2 = $23.97
TOTAL REFUND $60.85
Return to:
The Martinez Group
2405 Horizon Road
Burnsville, Minnesota 55337
Thank you.
i 0 1
Lynda S. Alle V
Building Services Assistant