HomeMy WebLinkAboutBuilding Permit 09-0533
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(
White File
Pink City
Yellow Applicant
PERMIT NO. (!)i _ <;"~3
ZONING (office use)
LJ " f ~L.V ooSx A.
.A
S6
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER 1\ ,
(N ame) . : c & 'C
(Address) J -:;-S- <t
L-dt'll#~
L-v ~( We) cJ ~
(Phone)
; ,/,
513
(Phone) 9 '5!:l,- If-y;) - r "30 S<
(Phone) 4 C;. ';I - /.r.o 4 I
TYPE OF WORK 0 New Construction
OAddition o Altera
CODE~. I.R.C. DI.B.c.
Type of on ction: I II
Occupan Group: A B E F
Division: I
Deck OPorch ORe-Roofing
OUtility Connection
ORe-Siding OLower Level Finish
o Fireplace
o Misc.
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST/VALUE S
(excluding land)
I hereby certiIY that I have lllrnished mformation on this application which is to the best of my knowledge true and correct. I also certiIY that I am the owner or authorIzed agent for the
above-mentIOned property nd that all construction will form to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that thc building
official revoke this pe. it for Just cause Further I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspectlOns.
......
'.20 ';;J 19 '7 ~ :s-
x
Contractor's License No.
Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
# $
# $
$
$
# $
# $
$
$
$ { (p. '>
I ~~iPtNO /t~~~
I ~
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
,
TOTAL DUE
~~~ jrq~
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any
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PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS ( S-" 7e>"3 WtVD~ ~l (( .
TYPE OF WORK lO.,c \ <\ ~~
USE OF BUILDING Res ~
PERMIT NO. ~_.5"S 3 DATE ISSUED
BUILDER N6-v A-~ PHONE #
NOTE: THIS IS N T'A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR f:4
I FOOTING If~ E'1-. I ~~ eLJ 1/t.e .
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
.... I I
I FINAL I (i; I '-Plott
FOR ALL INSPECTIONS (952) 447-9850
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