HomeMy WebLinkAboutBUILDING PERMIT 16-1306 ��l RIo�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
/ �9 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ((� -7 (é
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"`,�___ i�' AND UTILITY CONNECTION PERMIT
�rtNNES �
1. White File PERMIT NO. ` •2 /3 (,�6
2. Pink City
3. Yellow Applicant
lease type or print and sign at bottom)
DRESS ZONING(office use)
«2a 6 k V\In%Pei C t r-CJ. .
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID el IS
OWNER
(Name) Iw 5,,- M OA (Phone)
(Address)
BUILDER
(Company Name tes (-N.)0,:�4 R%si,, L L.C- (Phone) Co t-` t L) 6 Z i
Ci
(Contact Name) 01 4bvl,1 (Phone)
(Address) ,-1 2. 4,‘-/xi,L.., �;kk 5 ( C iS4 ) nl i0 3 ir
TYPE OF WORK ❑New Construction ['Deck ['Porch Xe-Roofing ['Re-Siding ['Lower Level Finish ❑Fireplace
['Addition ['Alteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑Misc:
Type of Construction: I II IIIIV V AB
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $
�ivision: 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-ment•.ed 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/oke,, •i .ermit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
/ Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC —
#
Plan Check Fee $ Water Meter Size 5/8"; 1"; Css''r-s)State Surcharge $ Pressure ReducerPenalty $ 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 ,t $ ?
This Application Becomes Your Building Permit When Approved Paid I0 C C�2) Recei•t No. 1 J a;
Date l/.. 1,/6. By i /
Building Official Date /
is 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
en 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
ed.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372