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HomeMy WebLinkAboutBuilding Permit 11-1097 g O n O t,,o QOO 1 o a 3 n n n -3 8 o K . . g _, 0 m 73 2 2 73 73 to r 71 7373x m cm m m � ` ��kk�� � 2 t * g 1 2 k z 53 L... ■ 2 a S 7 O 0 %, @ % 0 z § i � . m m § x § � �■ ! ■» z R R ��� 000000 0 .,.... ■mm m��, .� cz § ° m n : $ ), m , - >0 0 E 0 m q / �z . c % 0 F. m � �� 0 = m ,) c 8 ( 0 000000 t 's-3...„ .o E § 0�11 n§ 4 ), 0 © o mmG) \ i P555§ \ nn q PI 73 mp � 2 k§ B OF PR /� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE !Ll / 7. / / .. AND UTILITY CONNECTION PERMIT � ~��NBSO�� I White File z. Fink city PERMIT NO.// (0 77 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) /s'osict A ppc,JceS; Ti ,l tv /< • /cc / i LEGAL DESCRIPTION (office use only) / LOT BLOCK ADDITION PID OWNER _ n (Name) S / t--71) L' /Jy y t.' i JC (Phone) (Address) BUILDER (Company Name) ! 7 /1 9 5 A Vliv je - / fi Hi , Z Y S (Phone) C 1 . J 1 - b 6 O) h (Contact Name) / J,,' --, 0d 11,6 c 1 /� (Phone) (Address) J,,tvl 7 i4 ;c-:Jf( f , .� go -4.4/» /A; /1.41, J", 33 7 TYPE OF WORK ❑ New Construction ['Deck ❑Porch e- Roofing ❑Re- Siding ['Lower Level Finish ID Fireplace ['Addition ['Alteration ❑Utility Conne io' 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 hereby certify that 1 have furnished i ormation on this 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 property 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 this permit for ju cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. Si gnatur - e ' 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( 7S This Application Becomes Your Building Permit When Approved Paid 7 R e pt No. (0 4 7! Date /0.17 7 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