HomeMy WebLinkAboutBuilding Permit 10. 0314 •
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�' '� �a._a.-. .....la iLL11 II kJ 1 jjj%1V11 i, uate Kec'd
�� !\ ` TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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I.
White File
-. Pink City O PERMIT NO. 1 V
31 I
•
(Please type or print and sign at bottom) 3. Yellow Applicant
ADDRESS
SC!Q (A C 035C0\3,
35o _ \ (a- 5 • S ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name) Ao1/4.4c. Q ' �7 /TI h S U`e..` (Phone) !$ i/ T•tit/ •(Oc�D
(Address) /)
BUILDER Renewal By Andersen
(Company Name) 1920 County Road "C"West (Phone)
(Contact Name) Roseville, MN 55113 ,
(Address) License#20130983 (Phone)
651-264-4777
TYPE OF WORK 0 New Construction ❑Deck ❑Porch
❑Alteration ❑Re-Roofin Re-Siding ❑Lower Level Finish 0 Fireplac
❑Addition ❑Utility Connection --i,410 01/4_C 2 Q �lJl mot_!�,S c.„, n
CODE: DLR.C. D 0 Mimi.: �'LB.C. -21•;$+i �o" 'f ' l `�
Type of Construction: I II III IV V A B � t
Occupancy Group: A B E F H I M R S
Division: EJECT COST/V• 1 n _a
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 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 rev this permit f 'ust cause. Furthermore,I hereby agree that the city official or a designee may enter upon the
propertyto perform needed inspections.
tions.
X Or\O ot DoRgS
2(Dkpf;1io
Signature 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
This Application Becomes Your Building Permit When Approved I Paid 7(, all
ceipt No. &4/6
Date f 2-9, CU /
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
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 Special Conditions,if any