HomeMy WebLinkAboutBuilding Permit 15. 1106 E O o
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opiPR� t CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 9'`i 1/ l
40/NESolt. IWhite File
.z. Pink city I PERMIT NO. 1 I3 Yellow Applicant15ase type or print and sign at bottom)4,11
DDRESS
It 'q(0O % X14.
1$ TO 1 .C
,Mk 5 g ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT /I BLOCK ADDITION /3/1:4/-0047 7d -/c)��ei PID _O 17/ .0
OWNER
(Name) ,'. M LAUX.5Yve,C (Phone) (01 9-5 3 P-1/0
(Address) I
BUILDER t
(Company Name) i' `Q-five,, zt A \elef e_iN (Phone) &SI-a(Dy-(Ogg`
(Contact Name)
(Phone) Ilt& Tdd
Q
(Address) Mao aO CA ( "C 4' �e54 ; •��t/;tk� MN 55113
TYPE OF WORK ❑New Construction ❑Deck ['Porch DRe- oofing ORe-Siding ❑Lo r Level Fini IF,re�lace
❑ d ['Alteration ❑Utility Connection
Q` I S w1 t�3Sm � '
CODE: ❑I.R.C. ❑LAdB.C.ition 0 Mtslc. w/•I .Q�(f� J�tr��
e of Construction: I II III IV V A B
i Iliput
pancy Group: A B E F H I M R S U PROJECT COST/VALUE $ &c') --
vision: 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-mentione property and that a 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 can rev a this permit forju Ise Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X a • ' 4" C— 13 C�9S37-
Signature �'�/�
Contractor's License No. ate
Permit Valuation Park Support Fee # $
Permit Fee $ /- SAC # $
Plan Check Fee $ 5 Water Meter Size 5/8"; 1"; $
State Surcharge $ 1A. Pressure Reducer $
Penalty $
Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee ## $
Mechanical Permit Fee $ 77- Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE / $ a7 5 - '7 S
This Application Becomes Your Building Permit When Approved Paid / �
i�r /I� Receipt No. �/�V
Date vt . C % By Sq ,
G' "
Building Official
Date
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
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
_. red.
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