HomeMy WebLinkAboutBuilding 06-0674
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF WNING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~<<::.-:
I~::;:_ ";l\n'~' ~OMM,
Date Rec' d
~ Et ~ico" I PERMIT NO. V6 --6 7q
I I WNmG,__> I
'S+.~~,L6 .
LEGAL DESCRIPTION (office use only)
IfdJh"\
l S+PID .- - oesOI 0 - 0
LOT"7 BLOCK
ADDITION
OWNER
(Name) mil r-~h~ \ d- I er i \
(Address)
.\-\ (') c~ co",~
e..t'0\ S+, "S.lA.? '
(Phone) q-S';<-Y '-1,-05.;1..1
BUILDER
(Company Nam
(Contact Name)
(Address)
Twin Cities
Siding Professionals
664 Transfer Rd. Suite 22A
St. Paul, MN 55114
(Phone) L" <:5 I - .~ c:s s - ,~s-y '-\
(phone) ~ '5 1- d-.S S - c::z ":S'"I...! '-I
Ann Me.,'\ \"\0
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing )s((Re-Siding OLawet' Level Finllh 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc. /"""\-
CODE: OI.R.C. OI.B.C.
Type of Coa.smu:tion: I
Occupancy Group: A B E
DiTision:
II mlVVAB
F HI MRSU
1 2 3 4 5
PROJECT COST IV ALUE S
(excluding land)
I hereby ccnify thall have lUmisbed informalion on this appJicalion which is to the bell of my knowledae true and com:a, I a1so certify dW I am the owner (JI' authonzcd aRmt for the
above-menbOnl!d property and that ill COIISUIICtion will caaIorm to all exillina stale and loc;aJ laws and will proceed in ac:curdance widI submitted plans. I am aware that the buiJdinl
oft"lOa.I Itr this permil fur just cause. . Furthcnnore. I hereby "Jree thal the aIY ofIiciaI or a cksignce may entrr upon the property to perfbrm ~ ~ns.
X ' ~ e:>C.-~03l)\Oq- ~
ignaaue Contractor's License No, Dare
Permit Valuation .~~ t)oO. Iff)
Permit Fee S 7
Plan Check Fee S
State Surcharge S
Penalty S
Plumbing Permit Fee S
Mechanical Permit Fee S
Sewer &: Water Permit Fee S
Gas Fireplace Permit Fee S
11Iis Application Becomes Your Baildini Permit WIIea Approfti
Buildilhl Officiol
Date
Park Support Fee # $
SAC # S
Water Meter Size 5/8"; 1 It; S
Pressure Reducer S
Sewer/Water Connection Fee # S
Water Tower Fee # S
Builder's Deposit S
Other S
TOTAL DUE S -, (/J , elJ
I Paid
Date
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'!'Ius 1110 catify that the request in the above applic:atlO1l and acxompanyina documents is in acconIance wiIIl the City Zoninl ~ and may pI'lICftd as requcsu:d. This document
when sipc:d by the City PWlner constitutes a lmIpOWy Cettillcate of Zoninl compliance and a1Iows cOllJttUClion to comllll!l1Ce. Rem occupancy, a CertifICate of C>c:c:upancy must be
issued
Pbaaing Dim:lor
Dalie ' Special Co.diIionI, if mv
24 hour notice for alllnspecdo.. (~:Z) 447-98!lO. fax (951) 447....145
16200 Eaale Creek Avenue Prior Lake. MN 55372
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