HomeMy WebLinkAboutBuilding Permit 09-0428
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
t.Zc,.O/
I. White File I PERMIT NO r
2. Pink City . - LI ~ ...
3. Yellow Applicant =t- e".Ci1
ADDRESS
1(P~Olo
ZONING (office use)
Dvd l.(. TK A-UG.
S'E
P\<..LC.IL lAlL6
rvtrJ
c;~37
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
-1
~f(lVlJ
PID 2-S. \~. DaL 0
OWNER
(Name)
~A-VlA-6 'S
)Co~O(o
KINj~,L
Uu.. \ vcrH ~uG.
Sf
(phone)
P\<"l~(L LfHLE
C/.j-z - C;c.( r) ,.' S-!!7J-
mf'J SS'3
~.
(Address)
BUILDER
(Company Name)
(Contact Name) 1J/2 ft'+N 1-(;2-0/1) PHe:1Z. 'sc.tN
(Address) t q / /l1~ FA,o,otr,..rJ J /2.t4-r / E=/46Ari
C';t jZtJ /O.s
Co,...r .J /",2 U '--''fl...r ,..../
LL
6 S I' 7 JJ- - 7 I C( 7
6 S/-70j- '71 if l'
TYPE OF WORK 0 New Construction
DAddition DAlteration
eck OPorch ORe-Roofing
DUtility Connection
ORe-Siding
OLower Level Finish
o Fireplace
CODE: OLR.C. OLB.C.
Type of ConstIUction:
Occupancy Group: A B
Division:
o Misc:
I
E
II
F
1
ill IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST/VALUE $
(excluding land)
(0..000 . 00
I hereby certil'y that I have furnished information on this application which is to the best of my knowledge true and correct. I also certil'y that I am the ow r 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. am aware that the building
official can r e this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed insp ions. i
X ~'. . OJ /'#/~
Signature Contractor's License No. Date
#
#
Permit Valuation Park Support Fee
Permit Fee $ SAC
Plan Check Fee $ Water Meter Size 5/8"; I";
State Surcharge $ Pressure Reducer
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
#
This is to certil'y that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance an ay 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
24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
Special Conditions, if any
------
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS I~' flY IJJJ/,J./7H AVI&
TYPE OF WORK ~
USE OF BUILDING l'
PERMIT NO. DATE ISSUED II. 2". tJ,
BUILDER J::IN~" PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING ~
PLACE NO CONCRETE UNTIL ABOVE HAS BE
1.1JIl. H _~ I I
I FINAL I II 1#/
FOR ALL INSPECTIONS (952) 447-9850