HomeMy WebLinkAboutBuilding Permit 13. 0978 n O 0000 I 0 > 20
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01„pRlo� Q...... , Date Rec'd
4,7 /fr.� ~'rte CITY OF PRIOR LAKE BUILDING PERMIT,
1 / 11 \ i TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
v,r
AND UTILITY CONNECTION PERMIT r
13
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.ate C2ri PERMIT NO. 13
3. Yellow Applicant / ✓
type or print and sign at bottom)
RESS '/,ik
(,� r Vl�/lit l`�/YC, ,.£ ,,71r i'0 r � ZONING(office use)
LEGAL DESCRIPTION(office use only) /
LOT BLOCK ADDITION PID, -?6---0 BJP)- OO/—Q
OVVNER Z. -PQ- uk lr1 e ..
G` (Phone) 6V2 -3 --3 l76.5^
(Address) s---'407( 01 !/' R aa/ s'
BUILDER a
(Company Name) CO 'l Pr'
(Phone)
(Contact Name) (Phone)
(Address)
iiranTYPE OF WORK 0 New Construction ['Deck ❑Porch we-Roofing ORe-Siding ['Lower Level Finish 0 Firelace❑AdditionQAleration QUtility Connection
CODE: I.R.C. I.B.C. 0 Misc:
of Construct ion: I II III IV V A B
cy Group: A B E F H I M R SU PROJECT COST/VALUE $4000'on: 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 prope • 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
official., revoke this. ..it for just Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x '-".e-ey-74.../.4,-i______
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ 711, 7 SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ 5-c eV 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 $ 7�
t� 7S
This Application Becomes Your ding Permit When Approved . 7 p (7� .3pr-Wil Receipt No. Col
4-9 ci s
C . �� Date C s_C� r By 5
Building rcial Date
i
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
gn
ed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be