HomeMy WebLinkAboutBuilding Permit 15. 1407 of PRic. CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE II �����
AND UTILITY CONNECTION PERMIT
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'yINNEsolt* i. White File /g15—
PERMIT NO.
3 Pink City /
3 Yellow Applicant 45— `
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
?2LEG352,4- 774W 6/7--
LEGAL
AL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
BUILDER ate,. / �
1 )
(Company Name) / ' (Phone) �J
(Contact Name) �� 5� (Phone) to CZ _ sc.-I-. Te71-74
(Address)
TYPE OF WORK El New Construction ['Deck EPorch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
['Addition ❑Alteration ❑Utility Connection �/ � ,�
CODE: ❑I.R.C. ❑I.B.C. 6d disc. �_-�1=i .
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 a•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-mentio d ,ropetty d 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 ca evo,.this p it just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X . `/ ll"-/ —/
Signature Contractor's License No. ate
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $ Q.-a-D
State Surcharge $ Pressure Reducer $ 100—
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 $ 7#o 0 D
This Application Becomes Your Building Permit When Approved Paid 740 60 Recei. o• o. 34,--,:. V
Date 1/. 75_Zs' By /J//
Building Official Date
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 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