HomeMy WebLinkAboutBuilding Permit 10.0020 -
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of PRIOR CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE I I . ID
U N 2,-AND UTILITY CONNECTION PERMIT
,NNEsoI PERMIT NO.
I. White File
2Pink City 10 �0 O.
l
3. Yellow Applicant
VYlease type or print and sign at bottom) ZONING(office use)
ADDRESS
/ (aD?' I 2va(15-40 n Acs .
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
✓�
OWNER
(Name) (Phone) /s 4/---/ G �
� �
'�� �
(Address) /(a, �g , ii ci`/,S ,i'1 /9
BUILDER A , D - 0.9c5 CA..-C:v CO/7 � Gy7�O/�� (Phone) �j ` 9 C����Q�
(Name) L� �ylU'
(Contact Name) Tegpcya
1l7T7' (Phone)
(Address)C/ 9 0 C ,/-1 a // S/ Q g�,''? � ,.Sr/o /ff
L J
TYPE OF WORK 0 New Construction ❑
Deck ['Porch ❑Re-Roofmg ORe-Siding
['Lower Level Finish ■ Firlacep a ❑Addition
['Alteration ❑Utility Connection
/e misc./3 CiC-�)`,SQ oc),s '! •OJE T COST/VALUE (excluding land) $ -7 S---/ ,
•- eb certi, + . .•a.".ss e• in omatton on is application which is to the best of my knowledge true and correct. I also certify that I am the owner or
to
existing state and local laws and will proceed
author :,s. I am aware that the building officiald ''evoke thall is permit for just ction will ocause. Furthemo e,I hereby agree that the city officialior accordancen designee may
submitt
ent- pon the prop perform needed inspection "3579,-3
E /
r , I /6070 � 579, /-7 /
X ��� '�: Contractor's License No. Date
Signature
Park Support Fee # $
Permit Valuation # $
Permit Fee $ SAC
$ Water Meter Size 5/8"; 1"; $
Plan Check Fee $
State Surcharge $ Pressure Reducer
$ City SAC and WAC # $
Penalty # $
Plumbing Permit Fee $ Water Tower Fee
Builder's Deposit $
Mechanical Permit Fee $ $
Sewer&Water Permit Fee $ Other
Gas Fireplace Permit Fee $
TOTAL DUE $ 740,. v C)
This Application Becomes Your Building Permit �1 '. £'V eipt No. ._,57360 Iit When Approved Paid /L /O B
Date ,
Building Official Date
when1 This is to certify that the request in the above application and accompanying documents is ce with the City Zoning
dinance and may proceed as
ed.
ent
signed y the City Planner constitutes a temporary Certificate of Zoning compliance in andcallows construction to commencer Before occupancy,a CertificateuoftThis Occupancy must be
'ed.
Planning Director
Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
16200 Eagle Creek Avenue Prior Lake,MN 55372