HomeMy WebLinkAboutBuilding Permit 13. 1007 I n O DODO m o > E0
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of PR�0 CITY OF PRIOR LAKE BUILDING PERMIT, e/ Date Rec'd
A. r TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
Z"...) AND UTILITY CONNECTION PERMIT l ' /3 - /3
4Fin'NBSollk
I. White File PERMIT NO.
Li Pink City V/7)
10 07
3 Yellow Applicant
type or print and sign at bottom)
DRESS
ZONING
Ilse
5350 1,1,0 r T1�A ` (office use)
LEGAL DESCRLPTION(office use only)
LOT BLOCK ADDITION PID
OWNER "�
(Name) -5-e 3c flit r (Phone) v../e?‘ SO8—"
(Address) 5 ,5f.-0?) SV40(4.•, Cie/L., I N v
(CompanyRName) �(f �} cg w
(� `� (Phone) `a '7 a
(Contact Name) V f�1:--)1 re/ (Phone) (--
(Address) /(1 785 �,,i! /Indri, (ILA/ S 7ll o
TYPE OF WORK 0 New Construction [Deck DPorch Roofing ORe-Siding ❑Lower Level Finish
4
❑Addition DAlteration ❑Fireplace
111
CODE: DI.R.C. LB.C. 0Utility Connection
e of Construction: I II III IV V A B `
pancy Group: A B E F H I M R S U0
PROJECT COST/VALUE $ /g
ision: 1 2 3 4 5 (excluding land)
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 pro erty and that all construction will co -- .all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official ca a this rmit for just c e. Furthe•••. . agree that the city official or a designee may enter upon the property to perform needed inspections.
- - ' 2 3 503q R/13J/3
Signature Contractor's License No.
e
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee I $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 7 4 7S
This Application Becomes Your Building Permit When Approved Paid 7< 'Z S
7 R:,• ipt No. �40
Date /3 / l • I
AiiiBuilding Official Date
ir
s 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
•d.
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