HomeMy WebLinkAboutBuilding Permit 15. 1107 5 0O n 1:71443 El CI 0 V 0 > g
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pc PRtp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
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TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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'�I�rNEsp4�' I. White File PERMIT NO. //02. Pink City
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3 Yellow Applicant
ase type or print and sign at bottom)
DDRESS
ZONING(office use)
I y��-S o►ln-i-t r Lane_ f\) _.. k/
LEGAL DESCRIPTION(office use only)
LOT TLBLOCK 6 ADDITION PID R.6- ,A9,0-104,--o
OWNER ---0
(Name) ( 5 VA Ou>e—1 k (Phone) 959 LIS I- CO(p(.p
(Address) 11
BUILDER �y ,,, ,f u p
(Company Name) �NaVe.W C.� bi 1\' ele,( ^_ (Phone) 1551—a(04(�7�_0�g
(Contact Name) r • ,,, p (Phone) r�1Q�d
(Address) , i� CO. "C't JSS4 S Alle1 cr SS 113
TYPE OF WORK El New Construction ['Deck ❑Porch ❑Re-Roofing ❑Re-Sidin ❑Lower Level Finish El Fire e.,
❑Addition ['Alteration ❑Utility Connection �� ` 1 CA/jO t�
Mise. -P f7� I�"�O
CODE: ❑I.R.C. ❑I.B.C. ❑ r5 ��Q.e/rQ
e of Construction: I II HI IV V A B PROJECT COST/VALUEY $ /t1 7,9V-,
pancy Group: A B E F H I M R S U (excluding land) /
vision: 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
abov--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
off i l can revoke this pe it or Just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
i _ 11.---i _ib crr 13C L098,937- 9 /5
Signature Contractor's License No. ate
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ 61 Water Meter Size 5/8"; 1"; $
State Surcharge $ A i V,1, Pressure Reducer $
Penalty $ V ` 1' Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $ c' /7<---
Gas Fireplace Permit Fee $ TOTAL DUE $ /, '
This Application Becomes Your Building Permit When Approved Paid 16. / Receipt No. PI
Date " 1 • 1!/I ` ( , By �J
AOBuilding Official Date
Iliis 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
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
led
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372