HomeMy WebLinkAboutBuilding Permit 09-0168 n O94000O D 0 > z0
A 0 \ 00 0 0 §$K2 z m% 7
0 a o q q 7 C---- ��
� Z 2 k
mm m z
\
cn
K qq > Z j d ® \K P Z -
& -.4 . > - @ n � 2 § ■
�� o > 0 / 0
- � 0> --1 a D m m
t=i 2 r `
-1 -n - o - o
\ m ? § 0 0 00000E
) § \ § / § pen *■� , -
0 a zo o m 1 >m
| \ K \ ) %§ ■2 %§ m 0
zi E m§ 0 >Ooo 0 2 2 m
$
0 \ 0 �`� X z . c
,•• z} m — ›-o -o P m
k 0 Ct
= m •
c _ 0
§ m 000000
q Z 2 222§2 , §
R. tl } ® r���
= a z >
$ z aoo�> SI
q • - 1 ' /
wr 0
r CITY PRIp
OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
° TEMPO RARY CERTIFICATE OF ZONING COMPLIANCE 9
' '? AND UTILITY CONNECTION PERMIT �" Z �� tl /
V A tr7
w
A ' /.' NE so�P I. White File PERMIT NO
2. Pink City 0/ 6, S
3 Yellow Applicant � •
(Please type or print and sign at bottom)
ADDRESS- (ii ZONING (office use) t -4 r -
....5-,
CC Ot
LEGAL DESCRIPTION (office o nly)
LOT BLOCK ADDITION PID OWNER Run G P f e i nSC 4
(Phone) I �� � ;1 1 _1 -
Phone
(Address)
BUILDER V d I � f ,� (ll �`I Cn / PpO Q - A I {FI � ,
(Company Name) �+ l
(Contact Name) p - (Phone) _
��� e win .� b
(Address)
St � ccAl- YE ,
TYPE OF WORK ❑ New Construction ['Deck ❑Porch J�IRe- Roofing ❑Re- Siding ['Lower Level Finish [I Fireplace
['Addition ❑Alteration ['Utility Conn cti
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify that 1 have ■ ished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authorized agent for the
above- mentioned prope - apti that all construe of on o 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 perv(i for just cause ` urthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
I X `/Ire —
Ay" . f.�nature r 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 $ 16 - ___
This Application Becomes Your Building Permit When Approved Paid 762 — Recei G 3 /
Date Q, 2.-14..0 y By i Building Of cial 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