HomeMy WebLinkAboutBuilding Permit 09-0434
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(,.~ 14..07
File
City
Applicant
I PERMIT NO. ()f!. 04-34-1
White
Pink
Yellow
at bottom)
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LEGAL DESCRIPTION (office use only)
LOT
PID 2.5'
BLOCK
ADDITION
OWNER
(Name) L~t, Yk:l....<-
(Phone)
(Address)
ZONING (office use)
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l.;t LfJ..~ --:J..6Q J..
(Phone) bl:1... 4 ~- ~C.1~
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BUILDER m" \.... f'l -*
(Company Name) I f\(.. ~~V\ c.l:"'\~"
(Contact Name) n,. ~ q",.. ROvA '"
(Address) ~/1.0S'" 1~ic... A~<- ,Uol'~el...t.. fl\n
L f,.. c..,
(Phone)
SS'o.s
o Fireplace
TYPE OF WORK ~ew Construction ODeck OPorch ORe-Roofing
. ~;dditiMAlteration OUtility Connection
CODE: ..JI.R.C. DI.~. 0 Misc.
Type of ~nstmction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding OLower Level Finish
PROJECT COST IV ALUE $
(excluding land)
I hcreby certifY that I have furnished mformation on this application which is to the best of my knowledge true and correct. I also cenifY that I am the owner or authorIZed agent for the
above-mentIOned properry 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 buildmg
;cial can voke t is per t for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the properry to perform 6i;1P7C;~'
Signature Contractor's License No. Date
Permit Valuation \0 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 $
#
#
#
#
~
,.
Dffi . ,
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 +~4--'1 P&6rJS/lNr .5712.661
TYPE OF WORK PO/6t!r1
USE OF BUILDING jt.eJ" ~//L
PERMIT NO. . tJ9. 04.34- ' DATE ISSUED t.29.-07:.,
BUILDER H/1Cb edW~N C1JN~. PHONE # 'fl.. +z..3. u1z-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
I FOOTING 1Vc.. I fJ ;} )07 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING l.~C>i{'.4r r~_ b~~ l,.I~ (~~1J 1<.l4. I 7 /~o lor
I FINAL l&i it I,ij c
FOR ALL INSPECTIONS (952) 447-9850