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HomeMy WebLinkAboutBuilding Permit 11-0665 5 0: O — 8 O'D0D0 g i g §n . oo ' O ■m 0 73 m tz r ri 73 xx z > 0 0 --o t . qq> \ 4 o ® �� z » n z § ■ 0 7 2 ' 0 z A S z � . n 0 % r q r z ■ % • o 3 , y % rn k 0 0 000000 m m mm m��t�� lfi c c 0 II E kt ��� ¢ § ■ �� E m 0 0 2 k -0 9 � r m 0 0 § - v • q 0 z "- z - z r § z § m � ∎ r�� P 0 2 ■ 0 X m k 2 0 1 W < 000000 _ o inn§ » 0 ■ - » 0 © c1, -o II x ` ( k 5 ���� 4 m x -n 7 r- 2 § . . a t z m � r 0 rc Ptti CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE . . x AND UTILITY CONNE PERMIT ti-, // 1n ~'NNBSO11 I. while File 2. pin, City ERMIT NO. ll � � Y � 3 Yellow Applicant (Please type or print and sign at bottom) .....\.... ADDRESS ZONING (office use) M'? (?I4S cal/ P C.._- LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID .... \ �. f . OWNER M' . . _I , d / SO (Phone)(1 3 7 (Address) 3 -7/ CssSf5L PL BUILDER (Company Name) (Phone) (Contact Name) 5 i" 1i-"� n _ (Phone) (Address) TYPE OF WORK ❑ New Construction ['Deck ❑Porch Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ❑Addition ❑Alteration ['Utility Conne i CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. Type of Construction: I II III IV V AB PROJECT COST /VALUE $ Occupancy Group: A B E F HI MR S U (excluding land) Division: 1 2 3 4 5 I A. ,.. I hereby certify that ave ' rnished information on • s application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for the above - mentioned p •erty d tha all cons tion conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revok his pe it for; st taus- rurth•- . c, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. 1 A _ L.,, 0 — Signa re 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 $ If 7.5 This Application Becomes Your Building Permit When Approved Paid i l : 4elpt No. 6, 1---3j Date y l 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