HomeMy WebLinkAboutBuilding Permit 15. 0710 0o .
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�� PRION CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
a TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �+
AND UTILITY CONNECTION PERMIT . /5
411vNes01P. I. Pinkke Cityie PERMIT NO. /5O
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3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
Z�ONING(office use)
voq L�1PYiOYL00C 31 j
2— Tub
LEGAL DESCRIPTION(office use only)
w 44.LOT BLOCK / ADDITION I-4.5.J OCCry2EJ AVal6P ID 2.5- 16/640
OWNER
c2.6,6 (si yeU. 313(Nam (Phone)
(Address) 7_130(1 (-4i,..°k 42,40/ bike- �N ss 312-
1 BUILDER
(Company Name) Se- (Tc
(Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK El New Construction Deck ❑Porch ['Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace
['Addition ❑Alteratio ['Utility Connection / � L � �p
CODE: ❑I.R.C. ❑I.B.C. E]Misc. N beck- 1 4ek o] � WL,
Type of Construction: I II III IV V A B
Occupancy Group: ABE F H, I MR SU PROJECT COST/VALUE $ /
(excluding land)
Division: 1 2 4 5
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 proper that all construction will confo to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke t 'i .er t for just cause. Furth o ,
It .y agree that the city official or a designee may enter upon the property to perform needed inspections.
X Ar ,. v
Signature Contractor's License No. Date
Permit ValuationGDD O� Park Support Fee # $
Permit Fee $ f & CJS. SAC # $
Plan Check Fee $ [( jQ Water Meter Size 5/8"; 1"; $
State Surcharge $ goo Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ i Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ /0 / 0 II
T,,s Appli io 'ecome: our Building Permit When Approved N,I .0`• B Receipt No. 1q
ate
vd, Aff
4 y
Buildin"!ifticial to tel: \.014"."-\°
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
4646 Dakota Street Prior Lake,MN 55372
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