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7 : Ni TEMPORARY CERTIFICATE OF ZONING COMPLIANCE uate 1<ec d
AND UTILITY CONNECTI
�, ON PERMIT
N1 E 50�
l. White File PERMIT NO. ,/ ,/
_. Pett City /� /1/_//�
(Please type or print and sign3. Yellow Applicant
7
at bottom)
ADDRESS
ZONING(office use)
1 (oq- Li \ Si \ (n ,
'�P
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER 1� �V�,t
(Name) � t l ( \f Gy
(Phone) /5p�.p�OOs, 3 3io
(Address) 1
.
BUILDER Renewal By Andersen
(Company Name) 1920 County Road"C"West (Phone)
(Contact Name) Roseville, MN 55113 (Phone)
(Address) License#20130983
651-264-4777
TYPE OF WORK 0 New Construction ❑Deck ❑Porch ORe-t-. Re-Sidin
g ❑ g ['Lower Level Finish 0 Firlace
❑Addition ❑Alteration ['Utility Conn- ;• Q-c..Q 5 L „'^ctd��� S ,'
r � 1,-)
CODE: DI.R.C. DI.B.C. 0 Misc: c-2J)C.; s-K r Cy-Q/Yl; '
t
Type of Construction: I II III IV V A B • '_ 4
Occupancy Group: A B E F H I M R " al i - WE.
Division: 1 2 3 4 5 (excluding land)
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 the
above-mention. • •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 building
official can revo..- ' permit for just..us+. Furthermore,I hereby agree that the city official or sker inter up9a4hgpsto perform need ctions.
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
�e detectors shell be located Water Meter SizzenS/81 a detectors shall l upgraded
Plan Ch 8C
§leepi-tg room s,$on each story, Pressure Redu P the requirements$of the IRC
State �r°ughaur the house. Battery
Penalty and halls t0 sluing r00MS Sewer/Water Cc i eeeleCto# operated
Plumbing Permit Fee $ Water Tower Fee #may instAlled in
existing structl,res.
Mechanical Permit Fee $ Builder's Deposit
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid l2 Re Ipt No. 6 OS 2.U
Date ( . 3. !cl By
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