HomeMy WebLinkAboutBuilding Permit 09-0977 0 a~
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NOV -24 -2009 12 58 P.01/01
OF P R /p�
CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
U TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ,/ Z •
r
AND UTILITY CONNECTION PERMIT
f 4'NES °�
1. Palm City NO. al, 0 977
z. Pink ca, 1
r. Yenow Apaitam
(Please type or print and sign at bottom)
' ADDRESS ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
( MA,Itz + Jo Z. r jWc ✓e / k j (Phone) _952 ' 'i- , 9/ 2- .
(Address) .5 l ! � /5 0 ti'.' .St .
_. __
BUILDER f
(Company Name) C x ' i t - , 1 / 7 ()Y / � n 01/4. h (YU (Phone) 91z . 884 - V & 11
(ContactName) skij eJ ,J ik rti (Phone) 6 /z-- V/0-5101'
(Address) 96 s- H ho/ 4 4 5 3 /00 M I.1 j /i )i, /iv 55 I
TYPE OF WORK 0 New Construction °beck °Porch CRe-Roofing ( Vac-Siding °Lower Level Finish 0 Fireplace
❑Addition °Alteration [Utility Connection r
CODE: ❑LR.C. DI.B.C. O Misc:
Type of Construction: 1 II 1111V V AB
Occupancy Group: A B E F 11 I M R S U PROJECT COST /VALUE $ /3 //36,
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have , mished inmrmation on this application which is to me best of my knowledge true and CoKCa, 1 Ow certify that I am the owner Os authorised agent far the
above - mentioned p d that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. 1 am aware that the building
official can revo • i . mil for just cause. Furthermore, I hereby agree mat Mc city official or a desiiseo may enter upon the properly to perform needol inspections.
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Signature Contractor's License No. Date
Permit Valuation Park Support Fcc # S
Permit Fee S SAC # ' $ •
Plan Check Fee . $ Water Meter Size 5/8 "; 1"; $
State Surcharge 5 Pressure Reducer $
Penalty $ Sewer /Water Connection Fcc # $
Plumbing Permit Fee ' $ . Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $ •
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee 5 TOTAL DUE $ —7( e et)
This Application Becomes Y o u r Building ramie When Approved Paid P/HILLUIll - I, t No. 's, ��
Date /e ie r.0 B
Building Official Data /
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 document
whim signed by the City Planner constitutes a temporary Certificate or Zoning compliance and allows cnnatnttaon to commence. Bdore occupancy, a Certificate of Occupancy must be
issued.
Planning Director -- trace Special Conditions. ifany
24 hour notice for all Inspections (952) 447-9850, fax (952) 447 -4245
4640 Dakota Street S.E., Prior Lake, Minnesota 55372
7(a .
TOTAL P.01