HomeMy WebLinkAboutBuilding Permit 13. 1126 ƒ n 410000 17 0 > E
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`� P1P CITY OF PRIOR LAKE BUILDING PERMIT
8 ea
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Date Rec d
''. Ay-
AND UTILITY CONNECTION PERMIT
kiniso
1. white File I PERMIT NO. I
2. Pink City �— ) /�
ease type or print and sign at bottom) 3. Yellow Applicant (/
ADDRESS
/q/d3 ^� ktrd are
ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT/( BLOCK ADDITION�i�jt/�I iC/�/.. i�C/
7AMA) PID�`Jam'-o?/17/--OoqI-D
OWNER
(Name) Q i' te...4 LC/ Q.Y (Phone) 2- OZ-o/29
'/29
I (Address) 9/73 ( gi@ G'L1 ,•i". el; AlF
BUILDER �/ �" /_
(Company Name) �jhft4 , &r/fc9, G�d rl 4�p (Phone) (s/9Q.S-Ojas-
(Contact Name) �/� 11C� s v (Phone)
(Address)019/ .t-041c c c.� 4y'. 6-"i7)44(4 .....71 /. ss-/07
TYPE OF WORK 0 New Construction ❑Deck ❑Porch
41;i
DAddition ❑Alteration ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace
❑Utility Connection
L
CODE: DR.C. DLB.C. 42i21!eype of Construction: Misc: .40714/y C1�0OYii /77 .P�(/S�/
I II III IV V A B O
cupancy Group: A B E F H I M R S U PROJECT COS ALUE $ :37/9
tvision: 1 2 3 4 5
(excluding land)
I hereby certify that I have furnished informa'on 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 .o.... and that. . ,i ction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official f/IA,,
'��t for'.sa.Furthermore,I hereby agree that the city official or a designee may enter upon the property
X `// U/y1 to perform needed inspection
i /4 a /L J 23
/107. '/ ,Vesture_ /o1/7 /..,g
Contractor's License No. ate
Permit Valuation Park Support Fee #
Permit Fee $ , SAC
�� "� # $
Plan Check Fee $ Water Meter Size 5/8"; 1";
State Surcharge $ Od 5 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 9/1 VS-.
$ / r
This Application Becomes Your Building Permit When Approved fl ei "7S 7 G(( r
I Receipt No. ® Ic/
A
Date By
A\ lLi1163 (co ,C� - (j54
B ding Of'cial Date
Ilis is to certify that the equest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
n 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
ed.
Planning Director Date
Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372