HomeMy WebLinkAboutBuilding Permit #11-1078 ;❑❑ n oo❑ oo � o a Z�
y n � �R�Z ��I Q � C '
o � � ��� 3 r��c �o m � m n�
�' r � � � y m y � �' ��
�'i �'► "r "� -Di -�-I m � � z —
p � n� y � Z Z ��
� � O n �
� ° > -+ Z m m
� �
� o D z
� r � {
,� � v
� z °� � � oaooi�'o �
'�r m m m ���'��
�° "' v z i ° ° nc snc
�c =���_� m n n
� � m � � �� ; � m
,� O � � r��S Zo a . C
o Z ,, � ��v� o o �
� o � c�
� c A
y m OOOO�❑
� o � c����
�
� A >mm �� r
� m �"� � �; �` �
�
�� �
4 PRIO
��� ��, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� D� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �� �� �/
� AND UTILITY CONNECTION PERMIT
�
r `�'N � S�
�. wn�� File PERMIT NO. �/•� U'71��
2. Pink CiTy /
� 3. Yellow Applicant
lease e or ' t and si at bottom
ADDRESS ZONING (otsce use)
���� � �rS� ��� I�
LEGAL DESCRIPTION (oflf'ice use only)
LOT BLOCK ADDITION PID
OWIVER -- S �sz !J � ✓
(Name) 0 (Phone)
(Address) �� � � �� � � r5� �r I � Iee �l� �3 �Z
BUII.,DER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch �Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration �Utility Connection
CODE: ❑I.R.C. ❑I.B.C. I�Misc: 11-�/'�U✓E G✓�L (i /N L. �.
Type of Construcdon: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $
Division: 1 2 3 4 5 (excluding land)
I hereby certlfy that I have fumished information on this application which is to the best oF my knowledge true and correct. I also cerlify chat I am the owner or authorized agent for the
above-mendoned property and that all construction will conform to all e�cistlng state and al laws and will proceed in accordance with submitted plans. I am awaze that the building
official can revoke this permit for just cause. Furthermore, I hereby a e that the city ' or a designee may enter upon the property to perform needed inspe ' ns.
/d !�
X
Signature Contractor's License No. ate
Permit Valuation � U Q� Park Support Fee # $
Permit Fee $ 5 , �j SAC # $
Plan Check Fee $ � . Zr Water Meter Size 5/8"; 1' ; $
State Surcharge $ � S� 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 $ 4-/ , 7s"'
T7�is Applicarion Becomes Your Building Permit When Approved Paid - Rece' t No. G Z
Date a . /3 / B
Buildin Official Date � /� /���� �� - � � � � d �
L���� l/!'/ t�
This is to certiCy that the request in the above application and accompanying documents is in acmrdance with the City Zoning Ordinaace 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 D'vector Date Special Condiuons, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372