HomeMy WebLinkAboutBuilding Permit 09-0667
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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at bottom)
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White
Pink
Yellow
File
City
Applicant
Date Rec' d
I PERMIT NO. '1- tar;; 7
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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OWNER
(N ame)
(Address)
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BUILDER
(Company Name)
(Contact Name)
(Address)
4/lfAu-dnJh-~~~ ~~~
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(Phone)
(Phone)
....~ r'S
(Phone)
9J~ 9YZ-7VS-Y
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TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing
DAddition DAlteration DUtility Connection
CODE:\-4.C. DLB.c. JUJisc.
Type o~~~:Uction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
ORe-Siding OLower Level Finish 0 Fireplace
R€:-~ DEqL f=~-n'Alc.s'
PROJECT COST IV ALUE $
(excluding land)
I hereby certity that I have li.1mished Information on this application which is to the best of my knowledge true and correct. I also certity that I am the owner or authonzed agent for the
uction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
lllthe' ore, I hereby agree that the City official or a designee may enter upon the properry to perform needed Inspectums.
.Jot '5IS75 gjJ !/c:; '1
Contractor's License No. ~ Date'
\ X
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
S 00 -
z...:;.. "
\ <;P . "2-'"
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
~7~'i~
Paid
pate
/
#
#
$
$
$
$
$
$
$
$
$
#
#
I Receipt No. r ( Ie.
By (lI,)
This IS to certity 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 Celtificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake. MN 55372
Special Conditions, if any
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS Z~ 4j LJ I -0 _~ L~ N .0.
TYPE OF WORK S- ~c?<-~ ~ ~ F<9€Tr1~~
USE OF BUILDING ~ Me- I ~
PERMIT NO. ~1- &~1 DATE ISSUED z,/:s(-
BUILDER Au- ~CQ\3"-r- ' PHONE # '1~2. '&(42 .14~+
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATJ: OCUMENT
e--fl>~r!' pttf/l.. rt)Q/~~ A- ~v ~ '> /l.f{.If/l~ INSPECTOR
FOOTING - ~ NO ~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
DEPARTMENT OF
BUILDING AND INSPECTION
FRJl. ~II"" ~
FOR ALL INSPECTIONS (952) 447-9850