HomeMy WebLinkAboutBuilding Permit 15. 1440 O J Nw Z
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04-%.fPxlCITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
tv AND UTILITY CONNECTION PERMIT //.. 3o. 1-r
y/HHEWt.i's
I. white File PERMIT NO. `J�—�1� �
2. Pink City
3 Yellow Applicant
e type or print and sign at bottom)
DRESS / G 74. Q / t /o w 4 0 4 t n ZONING(office use)
O ( J R 1 S0
LEGAL ,4
DESCRIPTION(office use only)/' .
LOT BLOCK
1 ADDITION fi(/j f s 6Q I//0 PID ZS- aYi�OA&d
OWNER / i / t 0 111 [ / /
(Name) W l ` 5 �, /1 in( Cl ` (Phone) Q 'Sof Si Y 0 • 7 3 0 3
(Address) / L 7 ( % t ((o Lf L OA d, 5 Li
BUILDER THD At- Home Service, Inc
(Company Name)_ 2690 Cumberland Pkwy, Ste 300 (Phone) ? 12 /3 Y S • 1, 0 V 7
(Contact Name) _ Atlanta, GA 30339-3913 (Phone)
(Address) Lie# CR268257 Ph. 763/542-8826
TYPE OF WORK ❑New Construction ODeck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace
❑Addition ❑Alteration ❑Utility Connection ,�,//
❑Mise. L1 W/n u 4 W /`e 1)(6 UM a S /i
CODE: ❑I.R.C. ❑I.B.C.
of Construction: I II III 1V V A B f 1 ^ � A n Op f 5 2 '
panty Group: A B E F H I M R S U PROJECT C T/VAL $
(excluding land)
vision: 1 2 3 4 5
I hereby certify that 1 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 revoke this permit for just ca se. Furthermore.I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
XC R2 1 a s 7 11/ a 1/ S.
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ 1, SAC # $
Plan Check Fee $ • / Water Meter Size 5/8"; 1"; $
State Surcharge $ d� 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 $ ‘0,./c fl,s
This Application Becomes Your Building Permit When Approved Pale? 1Receipt No.
Date it ,--ZJO , 1�. By
Building Official Date111
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
igned by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction tot commence. Before occupancy,a Certificate of Occupancy must be
. d.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake.MN 55372