HomeMy WebLinkAboutBuilding Permit 11.0898 OtiFPR/ CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Q
AND UTILITY CONN CTION PERMIT l- �Z - ` �
19
44Amset' I. \ File
111 ins City PERMIT NO. / / ff/
V �1�Yellow Applicant 7
r Tint and sign at bottom) c... lIIVVVIII
ADDRESS
l 0 (5, L Vu:i\?9-°' ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name)
(Phone)
(Address)
B
(Company Name JOG,^Sati /Ga � .7 / 2
/�f hone) � Y8/-419/
crontact Nam / ' / i _ /,e l (Phone
dress • 4 i 4 4‘.- (-/- ,,fra; /
TYPE OF WORK 0 New Construction ❑Deck ❑Porch ►'• Roofin
❑Additiong ❑Re-Siding ❑Lower Level Finish ❑Fireplace
DAlteration ❑Utility Conne tion
CODE: ❑I.R.C. ❑I.B.C. 0 Misc.
Type of Construction: I II III IV V A B
•
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $
Division: 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.crty and , at 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 revs . permit'ar Just ,use. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed trection:
//
t:na Contractor's License No. Date
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 $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 9 75-
This Application Becomes Your Building Permit When Approved 2 1 J� G,rl
Paid R eipt No. 3 G J g
Date 9 fZ` lj/ /J
Building Official Date
This 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
when 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