HomeMy WebLinkAboutBuilding Permit 12. 0870 Q
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o f PRIO CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 1,f.
.. m AND UTILITY CONNECTION PERMIT
44,NESOo" 1. white File PERMIT NO
2. Pink lily / �j /
3 Yellow Applicant L VVV
(Please type or print and sign at bottom)
'DDRESS s-? ZONING (office use) Ai6,
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
ame) r .' i A. /U (Phone)
(Address) e 1V ' `rte'
BUII DER Ol f � V 19
C":71
�1 •�. ,,.... ► .Tina. st - _ (Phone) /,�., / c�
.•.1 • Nam- , f 1 , ( Phone ) a. t a'3 e'V 7770
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av • , Cot 42_5 t / . (J Ai,/
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch Re- Roofing ❑Re- Siding ❑Lower Level Finish 0 Fireplace
❑Addition ❑Alteration ❑Utility Conn i
CODE: DI.R.C. DI.B.C. 0 Misc.
Type of Construction: I II III IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5 1
I hereby certify that I have furnished info r ' . tion o this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for the
above - mentioned property and that all c 1 tructi• will c• orm to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke this permit for just cau F er •r , ereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X �.�
ai'� I ` ^• ractor's License o. i��t Date _e — / .
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 79 7
This Application Becomes Your Building Permit When Approved Paid 7.7 l Ceipt No. �Q Z
Date S/. Z. fL_
Building Official Date
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
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 be
issued.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 - 4245
4646 Dakota Street Prior Lake, MN 55372