HomeMy WebLinkAboutBuilding Permit 09-0496
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CITY OF FRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
&1-
Date Re(
7. /0, 07
1. White File I PERMIT NO a
2. Pink City .07. OAn/
3. Yellow Applicant ~
ZONING (office us.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Address)
BUILDER . U ~
(Company Name) eme ns+rrJ..c-n'VJ rbrJHj
(Contact Name) ]) f1 n/J... ~ ({)ruma .eh..R.-v
(Address) /)/J A.h rmCLnda.i.L Lab
(Phone) 99- ;};;)& - 1f1);J
::};}
95 J' 'jdl :;JI:::; S-
II
TYPE OF WORK D New Construction ODeck DPorch e-Roofing [( Re-Siding
DAddition o Alteration DUtility Connection
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
m IV V A
HIM R
2 3 4 5
o Fireplace
o Misc:
B
S U
PROJECT COST IV ALUE $
(excluding land)
/ l ~~S7J
x
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 t
above-mentioned pr perty 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 buildi
official can revoke . ermi r just se. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
~Olo9g'lJ?! 7/; /1J7
Contractor's License No. Date
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildinl( Official
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
$
This 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 documt
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must
issued.
Planning Director
Date
Special Conditions, if any
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