HomeMy WebLinkAboutBuilding Permit 07-0993
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13/3'1
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE, '
AND UTILITY CONNECTION PERMIT
1"114 S 1" on.,h .~ rf
Date Rec' d
I. While Pile I PERMIT NO
2, Pink City 'A"\7-~Q3
) Yellow Applica.. , ...... I 1_
w'--'
LEGAL DESCRIP110N (office use only)
LOTl... BLOCK -, ADDITION ~ (2-\P~Gs.,..., 2..0,
PID 25 -Z'l4 -oS4-o
OWNER.
(Name)
LiS tl S I 0(, II'-
(Phone) If ~ 1- 4 lll_ id 4 t1J I
(Address) i "11- 4 S'
Tc)y/)jA-tl ~ SE
TYPE OF WORK a.,New Construction DDeck OPordt ORe.Roofing
DAddition DAlteration DUtility Connection
, CODE: ~.R.C. OI.B.C.
Type of~~on: I n m IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
BUILDER
(Company Name)
(Contact Name) 111 t
(Address)5&l// /J;em()r/a./ A. /1.
(phone) bG/'~~9..y 3X)
.
(phone)
-S~ 8' ~
o Fireplace
PR.OJECT COST/V ALUE S <) lOt.( u -
(excluding land)
I hereby certifY that I have furnished information on this application which is 10 lhe: best of my knowledge true and correct. I also certifY tbat I am the own~'I" 0.. authorized agent ror lhe:
above.mmhoncd property and lhat aU construction will conform to aU exlstina sta~ and localiaws and will proceed in iICtOrdance with submiucd pIans. I am awa~ that the buildin.
~fficjaJ can ~t for J:):;;' FU11h~, I hereby a8= that Ihe d~~or; #~; enter upon the property 10 perform need; ~~i~ ,
Signature Contractor's License No. Dale
Permit Valuation '2 .::; <.9Q ..
Pennit Fee $ ....,4-7~
Plan Check Fee $
State Surcharge S (.. 'Z-~
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee S
Sewer & Water Pennit Fee $
Gas Fireplace Permit Fee $
Park Support Fee # S
SAC # S
Water Meter Size 5/8"; I"; S
Pressure Reducer $
Sewer/Water Connection Fee # S
Water Tower Fee # $
Builder's Deposit S
Other S
TOTAL DUE $ lto.- -
I Paid
Date
I Receipt No. 54 g 531
By rLiJ (4
l~' - I
I 0 .::; I cJ...,
ThIS is 10 certifY thallhe requcsI in Ihe above applicalion and accompanyin. documenlJ is in accordance with the Ci~ Zonin. Ordinan~ and may proceed as requested. This document
whe:n sisned by the Ci~ Planner constitutes a temporary Ccrtillcate or Zoning compliance and aUows construction to commen~, Berorc occ:upanc:y, a C~'l'tirlCate ofOc:c:upanc:y must be
issued
P1anning Direc:toi
Date
24 bour notice for III Inspection. (~2) 447.98!1O, fax (~2) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372