HomeMy WebLinkAboutBuilding Permit 15. 0695 1, . #
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of rsiot CITY OF PRIOR LAKE BUILDING PERMIT, / Date Rec'd t
'' c TEMP RARY CERTIFICATE OF ZONING COMPLIANCE
nf AND UTILITY CONNECTION PE ' 0•/fr �. —
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'1 l01/' r wee Ce -PERMIT NO.
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(Please type or print and sigh at bottom) Yetbw Appiic>rip D� V
ADDRESS � �/
S1 I Epvt bu S S Ci y N Tr(office use)
Pei° r /14,Vc--S-3 �-Z
LEGAL DESCRIPTION(orrice use only)
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LOT ////
BLOCK / ADDITION 4��e/Z� �� PID c775---4(384 —114('—e)
OWNER
(Name) Core/ i RA/NIet/
'"� (Phone) 61 Z 7-S6 333 8
(Address) • I-1S e/ / Im bc. yor 4)i' Prior- 1,le.c. MA/ SSS 7
BUILDER
(Company Name) Coeve-y
Mere_'' (Phone) 612 - ?--S-G, —3338
I (Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction ODeck OPorch
[]Alteration ORe-RoofingRe•Siding OLower Level Finish 0 Fireplace
OAddition ❑Utility Connection
CODE: ❑I.R.C. O1.B.C. O Misc.
Type of Coad
nnction: I II III IV V A B
Occupy Group: A B E F H I M R S U PROJECT COST/VALUE $ 00C)
Division: 1 2 3 4 5 (excluding land) 1
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 lam the owner or authorized agent rot the
above-mentioned property and that all construction will conform to all existingstate and local laws and will
official can revoke this permit for just cause Furthermore.I proc1. eed in the property with perform
needed plans. I am aware that the building
hereby agree that the city official or a designee may enter upon the in iseirorm in ins
6 iSps-
Signatur Contractor's License No.
Date
Permit Valuation Park Support Fee # $
Permit Fee SSAC
Plan Check Fee S ��/mayvWater Meter Size 5/8"; 1"; S
r
State Surcharge S - / }
✓ Pressure Reducer 5
Penalty ' S S err Water Connection Fee #
Plumbing Permit Fee
$ $Water Tower Fee # S
Mechanical Permit Fee S Builder's Deposit
Sewer&Water Permit Fee _. S
S Other S
Gas Fireplace Permit Fee S TOTAL DUE _
This Application Becomes Your Building Penult When Approved P O I0 l eic 1,5— j L/
Receipt No. ��/
P to 65,__Z2...4 ._ By
ZI-----
Building Ullicial Owe J
This is to 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 constriction to commence Before occupancy,a Certificate of Occupancy must be
issued
Planning Director Date
24 hour notice for all inspections(952)447-9850 Special Conditions.if any
4646 Dakota Street Prior Lake.MN 55372