HomeMy WebLinkAboutBuilding 06-0514
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CITY OF PRIOR LAKE BUILDING PERMIT
,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rcc' d
ro(/'I /tJ~
rill'
Cil)'
AI-'I)h'hll(
PERMIT NO. tJ~ -05/'(
Wk.l"
Pink
:i Yellt\w
CS8a
C c::;d4 r~?'2.J_. 5 +-.
I ZONING (oiTlee UIC)
I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PLD
OWNER
(Name) L. (DdA
vu .Ll~ -S~
(Phone) H- - 9.:;;-0' -c{9G-cq,;;?<i
Pv 10 V' LA fC:.~__. ~ u.
(Address). S~BCJE:? Cc::r{A v 1.<...:. uc~l
s+
BUILDER ()
(Company Name) OA0Cf- Se-l-vlc::..eS Ifo..JC-,
(Contact Name) IL eu I~ "S A y..
(Address) '7 '30 u c:.. (,.( ~ f-l A 10 sf... 1-..)0 (L-4
(Phone) 7 (p '3 - <-l.;z I - I rz d ~
(Phone) '703 - if ~..__S- / ~ <.(
W ^.J S-~-3>o ~
TYPE OF WORK 0 New Construction DDcck DPorch jS(tRc.Rooting
OAddltlOn DAlteration DUtllity Connectton
CODE: &:1I.R.C. DI.B.c.
Type of [;;nstmction: I n UI IV V A R
Occupa.ncy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-SIding OLower L~vel Flllish 0 Fir~pl~(e
o Mise
PROJECT COST/VALUE S
(excluding land)
I hc,dlY certify lhall hay,' t\lInl$hecllnrOlm~BOn on IhlS apphcallon which" m the bl',r of my knllwll'dgc Bur .Ind cnlfeCl IllS" ~f'tflry 1M! 1,11'111. "W"~I'" ."'lh'''IZ"~ "gent lu;;h,~
lbllVC.ll t10fltJ PIl)\Jcdy .'llld Ih,\I ,\11 ~onU'HCrtOI\ WIll conform to .aU CX\:c;unS qaIC 30<.1. l()c~ll3.W1 ~od wIJll11l)~eed 11\ J),(l.'lll uJrlt I: wuh ~uhm'tlt:l' pla.ns ll\m aware' that ch~ bud(hn~
i nfftcl~1 a, rrvl)kc 1111$ P70r JII ~c Furrhel mMc, (hclchy AGrce that the City official ,I' .) de~:e_mBY enle' upoo tilt 1"\)t'<lIy 10 V~"\lrm netoc~ m~~"(IIUn~ ,
'LX ~-&. . .;;l.qJ~~ ~.~..2L-:_9!._1___. I
Sl?,l\arur Ct)nlraClur'~ Llcemo: No Date
Permit Valuation
Permit Fcc
Plan Check Fee $
SI<lce SurchJf!l(~ S ,Z-~
Pen aIry $
Plumbing Permit Fee $
Mechanical Permit Fee !i
~ Sl'WE:f & Water Permit fee I S
G,lS Fm:place Permit Fee I S
I
Park Supporr Fee
SAC
#
#
Warer Meter Size S/ll". I",
Pn;ssurc Reducer
Sewer/Water Connection fc~--"-'#-
Wmer Tower Fte
It
Builder' s Dcp()~lt
O~her
TOTAL DUE
s
$
s
$
$
$
$
$
S ~__
.--
Paid
Date
Tp'~7~ ~;"'~tJ-=
t ~J __
j:2' ^VPliCa(~,O" Bc:c~m:~ YOW' Building Pennil When Appruved
i ~.~~._ ~if.!O(p
~" ~lIIldiI1J~ Otljclal Dale
-------,
Th1~ I~ ~o (f..TUfy ih;J.[ IlkI'LlI'I!';sl III Ilh,' ,)\)ovt' :'JlrJlir..:;Ulllfl iln,\ ill..(;Umr,lnYll)~ (1U(\Imc.'ncs I~ in .lCCordilllcC Will\ Hl...~ City Luuin~ OnHnilncc i1nd mi\Y Ilrl)~l\.'(t .1;\ I\':(W\:~II;\J rlh:,; dUl'\If-:1l'nl I
whc:n :l:iE;nt.'d by !hl! e,l')' Plilllnc:r ~'lln:)lllutl.:): i,i1r:rnpUlill)' L~lfitKac\: ut' ZOl'\in~ l.:umpli.1ncL' ,md ,llll\w!( ,:,)IlSUUl"Ul1n II) commence Btf,)I'C I)CCl'l),'\I"''y. ;\ ((,,'\hlkiHl' \)t Ucnlp"IKY must be
1~.'iIIL'd
I
1____._.
Plunning DtreCtOf
n~lt
Special c.m~!tl?"!:. if ,Iny
6~:Sl 900c-~1-Nn[
-~'~,~';;i;u~ for all illSptrllOll1 (9~2) ~47:;j~sii.lax (')52) J47"J24~
10/10 - d
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