HomeMy WebLinkAboutBuilding Permit #13-087 � o❑� c� ooa�foa � o> y�
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� � CITY OF PRIOR LAKE BUII,DING PERMIT, �`' Date Rec'd
.. D'� TEMPORARY CERTIFICATE OF ZONIlVG COMPLIANCE
� AND U1'II.ITY CONNECTION PERNIIT
r � 5���
�: � �;�. PERMIT NO. ;[
4 � 3. Yellow Applicmt J- 0��
lBdC O! Y� S HL T/0Z[p�i
ADDBESS
O L � � zoNIl�TG co�«,��
3 �5S � .
LEGAL DESCBIPTTON (o�('ice use oniy)
LOT BLOCK ADDTTION PID
O�V1vER .
(Name)
(Phone) � S a - � �� ' �� � e /
cA��� � 5 s 70 � - t:� . � r��.D2�e I'Y� N ss �� a
B�� ���, _ G,f
(Company Name) � � . (Phone) (QS 1 ' � p'-i'� a- �o � �p
(Contact Name) (Phone)�S �� � �'-1- a�-�o� �
� caaa��s� � �( . � t�h N 5 Sv 1
`�E �F W�� ❑ New Construction ❑Deck ❑porch �Re-Roofing �Re-Siding �Lower Leve1 Finish ❑ girepiac�
�Addition pAitaation []Utility Conneetion
con�: pi.$.c. pi.s.c. ��_ � � �- �� a�7
Type of Const�ucbion: I II III rv v A B
0
Occ�auc7 CYmupc A B E F H I M$ S.0 pgOJECT CpST�ypI,US S � 1� ,�
��� 1 2 3 4 5 �� ���
��rebp�art� that I have Purnished infoxmaaoa oa this appHcaaon which is to the besc of my ]mowlaige true and ooaect. I aL4o c�ecbt�r tlut I am the owna or anthorfzed agent for the
propexty and that all con ' n will conform to all austing state and local laws and will proceM in acoordance with submitted plans. I am aware tLat the bnilding
official can this permit for jnst cause. amore, I haeby agee that the city official ar a desi�ee may enter upon the
PIOpertY ro peEform needed inspectiona.
X _ �IZOD/7� /-��•l3
S' ture Contractor's License No. D
Pamit Valuation Park Support Fee # $
Permit Fee $ SAC # a
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
P ��' $ Sewer/Water Connection Fee # $
e Plumbing Peamit Fee $ Water Tower Fee # a
Mechanical Permit Fee $ Btulder's Deposit a
- Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
.. 7�I _
This Application Bewmea YotQ Bnildina Pt�it Whea Approved Paid
R t
Date � g �-
Buildin Official . Date
This is to certify thaz the request in the above applicaaon and ac�mP�S'�B documents is in accordance with the Ciry Zoniag Ordinance and may proceed as re9aested. This documrnt
when signed by the Ciry Planner cbnstimtes a temporary Certificace of Zoning rnmpliance and aIlows constrnc4on ro crommena. Before oocuPancy, a Ctrtifica0e of Oe:cupancy must be
issued.
Planning Diredor Date Special Conditions, if e�•
24 honr notice for all inspecttons (952) 447_9g5p, faz (95y) qq7-4y
�b46 Daltota 3tr�at SE., Ptior Lske, Minneeota 5Si72