HomeMy WebLinkAboutBuilding Permit 11-0671 R. ❑ ❑ C) ❑L❑ ❑O❑ ml 0 D v -2c?
,�' 0 fpm — m TT
N Q 3i — IZN C O z m x m0
b D o 7) 7J z g m r r .. c 3z � Z - ccn -
m m y m N _ z D 0 O N O
hi - D ` z m 0 6 z -
z,
f0 D y
Im z , D z - z mm
hi m n D O •
1
hi
73 n z : 1
r
a = o , a
m 0 0 , `' ❑❑MOOD
XI hi x m m m �; �Vfp O
�m c c
-� N o o x3 v n u) i o z 0 m -. ❑ 2 73 X/ aj _ m 0 0
cn m zzxx — z z x
RI -4 r m 0 0 x 3 m
o z ' z C C Z r
0 . CO n >CC P m
0 z T r ■� 0
N
N = m
73 0
m 0000❑❑
h N m �` 0
z z
.y 2 , nmT0m D
a. D O m
D 0 cpmm30
< z�
D m v
Z D mm z T
ti m T7 Tx -4 r 1
N z — Z m
- r 0
O PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
F ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / !/ 7 L , ( /
06:
. x AND UTILITY CONNECTION PERMIT
Irj
~ /�N E S��� I. White File /
Pink City PERMIT NO , 6 7
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS II ZONING (office use)
17agn Town au. -
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) 0lC,it- OvAlcr- (Phone)
(Address) V1 V) Torte, au-L, /
BUILDER
(Company Name) C taCr f/ ^�,, ? CA .�`�s �� (Phone) (Q (a' -' R' O
(Contact Name) JQI� (acaak n 1 M,, (Phone)
(Address) L 69-60 G' :vv..,/o et r Y i L k 1' � 0
TYPE OF WORK ❑ New Construction ['Deck ['Porch [ e- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
❑Addition ['Alteration ❑Utility Connects n
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II 1II IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5 1
I hereby certify tha I have punished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authonzcd agent for the
above - mentioned p Terry and that construction will conform 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 , permit 1• ju ause F rmore, I hereby agree that the city official or a designee may enter upon the property to perform needed tn.spccuuns
Signature Contractor's License No. / Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
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 $ 7 9 75
This Application Becomes Your Building Permit When Approved Paid 7 9. 7 e eipt No. 4 34
Date i 04, `f
Building Official Date
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, fax (952) 447 - 4245
4646 Dakota Street Prior Lake, MN 55372