HomeMy WebLinkAboutBUILDING PERMIT 14-1141 o� pR1 / O//� ' 6 -G1 ( DC ,4174.6(-- ,.ii
/ 1 CITY OF PRIOR LAKE BUILDING PE n% I I' tit- Rec'd r \ 3 TEMPORARY CERTIFICATE OF ZONING COMPLIANDate Rec d
U\ , �' AND UTILITY ONNECTION PERMIT CJ
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lease type or print and sign at bottom) s. vCilew Applica"`
DRESS /J
/G9/V G✓1 G/ cfre Sze ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION 1/w c FM4 C ',w,�/ PID c„.--
OWNER // j�
(Name) //JX Y4 i%74./C" ��r'/.�/� /
/ � (Phone) LP�,'111Vr? '8��
(Address)/P 9/0 /_ti�//7v7 el iV.Z. <J 6) A:0-.-/Lvt.e) / 4 5573,2
BUILDER �J 1/
(Company Name) (1:726-2/0,1 ( ,f2(.5 liC /n / ,,..„6 , (Phone) "Q 73"/ 5
(Contact Name) c^ j,,-)y2� 5� �'J �C2�}l
C!, (Phone) �OJ` � 9�p 7-O3Ba
(Address) y A5 o��0/w„y `"(� ����
TYPE OF WORK 0 New Construction ❑Deck
[JPorch 'Re-Roofing 1e-Siding ❑Lower Level Finish 0 Fireplace
❑Addition ❑Alteration DUtility Connection
CODE: ❑I.R.C. ❑I.B.C. Misc: ��, /�� � /i/� l
Type of Construction: I II III IV V A B �
Occupancy Group: A B E F H I M R S U0 � /2 99 0 70 �`1 de"05 'e'f, -e')C/�'i" f' i �n .d
PRFJJECT COST/VALUE $ q�, opo_oo
ivi 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-mentioned property 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 revoke this permit for just c . Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
tgnature
Contractor's License No. Date
Permit Valuation 'j/ 7c--- ,744, 7:4- 74/ Park Support Fee # $
Permit Fee $ SAC
# $
Plan Check Fee ,x•196 , o U ater Meter Size 5/8"; 1";
State Surcharge 7q.75- -7'9 7s--- 7 73 Pressure Reducer
f J / / $
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( /../x/55(3�
This Application Becomes Your Building Permit When ApprovedPaid \7111Ilk % ir
,__ y . 4, , Recei s t No. /7625.12;
Date10 , 3 'cc” By scs......
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
iii,
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
ued.
Planning Director Date
Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372