HomeMy WebLinkAboutBuilding Permit 14. 0450 V
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oc PRiop CITY OF PRIOR LAKE BUILDING PERMIT, v
�+ c TEMPORARY CERTIFICATE OF ZONING COMPLIANCE f Date Recd
AND UTILITY CONNECTION PERMIT 61
4/vIvegOI'
I. White File
Z. Pink City PERMIT NO. `9, x'56
ase A.• or ,rint and si at bottom 3 Yellow Applicant
• �DRESS
ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name) 0---/ �Aid (Phone) � ���9— o74
(Address) S
IBUILDER !`
(Company Name) r_ ,p
(Contact Name) �. irs (Phone) ` /� 02!' _/3/p
(Address) (Phone)
d i L the Air L
TYPE OF WORK 0 New Construction
❑Deck 0UOty Conne toPorch ne-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace
❑Addition (]Alteration
CODE: DI.R.C. DI.B,C, 0 Misc.
e of Construction: I II III IV V A B
panty Group: ABE F HI M R SU PROJECT COST/VALUE $
vision: 1 2 3
4 5 (excluding land)
I hereby certify that I have famished 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 property 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 can revoke this permit for just cause. Furthermore,I hereby agree that the x city official or a designee may enter upon the property to perform needed inspections.IGS; 1� 1,/`l y
Signature
Contractor's License No.
Permit Valuation Date
-_- Park Support Fee # $
Permit Fee
1111111111111111111
Plan Check Fee $
Water Meter Stze 5/8"; 1", $
Penalty $
Pressure Reducer $
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 11111111111111. TOTAL DUE IVNABINIM
This Application Becomes Your Building Permit When A -..••pproved Paid � �
Rete!:t No. • ' -•
Date � B,/2
Buildine Official Date
is to certify that the request in the above applicatngion
n nt
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows documents is in nc<structs n to commence.the City Beforeoccupancy,inance and may acCemficat requested.
Occupancy tmust be
'ued.
Planning Director
Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 Special Conditions,if any
4646 Dakota Street Prior Lake,MN 55372