HomeMy WebLinkAboutBuilding Permit 14. 1007 E .0-1;1-0... n O 0000 o > En
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of PRIprP CITY OF PRIOR LAKE BUILDING PERMIT, C� Date
,� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
4
v AND UTILITY CONNECTION PERMIT
��'�NESOi� I. White File PERMIT NO.
2. Pink City N /
3 Yellow Applicant
ease type or print and sign at bottom)
ADDRESS ZONING(office use)
3(u SAorsk Al.:\ \v,, 4i
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID,45-55264/
382r�L,(
W
OWNER. ' �`
(Name)NER \y t Sk y L - (Phone)(t? ) 7A2 - gM
(Address) 3 12 „. \\\J
BUILDER n_ L
(Company Name) lit oec C A5'I;t.T`6V\ (Phone)(5 -7<-7 r C4( .
(Contact Name) D/4 u)t- lAib C3h. t"1 (Phone) 5A.w
(Address) `..- 1,5-- W i rj S, <>te 1 G4
TYPE OF WORK ❑New Construction ['Deck ❑Porche-Roofing ❑Re-Siding ❑Lower Level Finish IllFireplace
❑Addition ['Alteration ['Utility Conne t n
411,
ODE: ❑I.R.C. ❑I.B.C. EI Misc.
e of Construction: I II III IV V A B PROJECT COST/VALUE $
cupancy Group: A B E F H I M R S U (excluding land)
ivision: 1 2 3 4 5
- uy cert[' hat ha ' 'rmi ed 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
menti. e, proper and t till construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
officia - revo i ti is pr r u.�:•. cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform ne' ed inspections.
11 1 6 i ..• \ -) 73c.-_, 657 2./.3<-" -? •71/1 (0-f-xP''''
Si;, ature Contractor's License No. ate
Permit Valuation Park Support Fee # $
Permit Fee $ 1,
7X 75" SAC # $
Plan Check Fee $ / / Water Meter Size 5/8"; 1"; $
State Surcharge $ ,h/1 Pressure Reducer $
Penalty $ (�C 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 $ 77' 75-
.
This
97-
This Application Becomes Your Building Permit When Approved Paid 9-4*,......_ _ Receipt NWE543)
�S�
Date '7,1By /�
Building Official Date
•s 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
en 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,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372