HomeMy WebLinkAboutBuilding Permit 15. 1355 (opiPRJCITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE . /AND UTILITY CONNECTION PERMIT l / ` 1 ct,r
NESC�� I. White FileCPERMIT NO. /�,
�``
32Pink Applicant /
3 Yellow A licant
(Please type or print and sign at bottom)
ADDRESS
/?7 ` f � - ZONING(office use)
e,,-,A, .ii/..,?1,
LEGAL DESCRIPTION(office use only) l) , r CCom�//''
LOT BLOCK ADDITION Xe � . ZkID '-. 67-D/3—"0
OWNER ' P / e ' `_�
(Name) III. 4616 (Phone)
(Address)
1 BUII,DER
7(Company 19- (Phone)g52 "/7(o7--/bon
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑New Construction ['Deck ❑Porch DRe-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
❑Addition DAlteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5 •
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
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 building
official an r yoke this pe••.it for t •us- ur rmore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X !/�� - Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"• $ 54 61' Oa
State Surcharge $ Pressure Reducer $ / (��j(/r
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 I $ TOTAL DUE '' $' 7� 00
This Application Becomes Your Building Permit When Approved Paid Li a at Recei i t No. 3 3A '
Date 1 ' B
Building Official Date 6/A-&-"��
This is to certify that the request in the above application and accompanying documenta�fn ac' cordance with t e 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
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372