HomeMy WebLinkAboutBuilding Permit 15. 1166 0
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•� CITY OF PRIOR LAKE BUILDING(c '
c TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Date Recd
tll AND UTILITY CONNECTION PERMIT
��� '�rVBS. V /
,. White File
e or ' t and si at bott 2. Pink City PERMIT NO.
RESS Offi) 3 Yellow Applicant
11 �1 i I1 ../� � I l J� £ �, Lake_( ZONING(office use)
LEGAL DESCRIPTION(office only)
/r'�
LOT5BLOCK DDITI01Vi~ c.A-/CS z lU.� TT
OWNER NO PID t95--Oee b�a.05 dr
(Name) CU,.
(Address) (� �� fi (Phone) S. I.lb "1.7 76
BUILDER
(Company Name) '
� �a';�,1,C-�e�
(Contact Name) 7 i -.0--- (Phone) • Its
(Phone)
(Address) -1(1 00 l' w v'
I, I YYIt ''393
TYPE OF WOR 0 New Construction
°Addition °Deck °porch •e-Roofing QRe_Siding ['Lower Level Finish
QAlterahon ❑Utility Connection
CODE: ❑Fireplace
❑LR.C. ❑LB.C.
of Construction; 0 Misc.
ancy Group: A $ II IV V A B .
on: 1 Z I M g S U PROJECT COST/VALUE $
3 4 S (excluding land)
) I hereby certify that I have famished information on this a I
I al
pplication which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
official can revoke��and that all consrrurtian will conform to allexisting state and local laws and will
permit for just cause. Pirrthermore I hereb agree that the rut official or designee ma proceed in accordance with submitted plans. I am aware that the building
X ( Y enter upon the o
. property to perform needed inspections.
Signature 674 I (__IL__as_Ais_L___
NurContractors License No.Valuation Date
Park Support Fee
allWater Meter Size 5/8"; 1"; 1111111...
mimon
Penalty ,� Pressure Reducer
Plumbing Permit Fee Sewer/Water Connection Fee #$
$
_
Mechanical Permit Fee Water Tower Fee #
Sewer&Water Permit Feeaglininellill Builder's Deposit
$ UIIIIIIIIIIIII$
IIMMll
Gas Fireplace Permit Fee Other
gIIIIIIIIIIIIIII TOTAL DUE ENIE
This Application Becomes Your Building PermitWhen Approved
Paid tl/ 4
40
Date
j B
Recei.t No. ��`��-
Building OfiDrial %
'Date ' ,+
certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may
ed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy.
proceed as requested, This document
a Certificate of Occupancy must be
Planning Director
Date
Special Conditions,if any
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