HomeMy WebLinkAboutBuilding Permit 10.0276 J
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( ----- PR:i f --
f � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
it TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ii, ( O
AND UTILITY CONNECTION PERMIT
s
A' I. White File PERMIT NO ` 0 OZ
3 peII Applicant icant
3 Yellow Appl �
(Please type or print and sign at bottom)
ADDRESS
ZONING (office use)
,r6 C// 7:::,4. 1.4.t... /o
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER /
(Name) / v / & / 5 e (Phone)
(Address) 5-6 // - 7, - - 1 ,4, ! h e-4-� /k✓
BUILDER
(Company Name) (_ .. -' 8� , � S �o n E. ( Phone) .5 92 - C / YS 7
(Contact Name) C�„ S (Phone) __
(Address) 1 /J'7 /-,i-/.7 �/z elite - 0er
TYPE OF WORK ❑ New Construction ['Deck ❑Porch 012e-Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
['Addition DAlteration ['Utility Connection 0 Ge 7 4 dove , 'A' e., o7 - e.s.4
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B PROJECT COST /VALUE $ 7 SD o
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
i
I hereby certify that I have punished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
above - mentioned property and that all 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 revepothis permit forrins ► cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Ct1-- .
Signature Contractor's License No. Date
Permit Valuation te5'0, Park Support Fee # $
Permit Fee $ Z,) _ -- SAC # $
Plan Check Fee $ ' co. z- 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 I $ Other $ -
Gas Fireplace Permit Fee $ TOTAL DUE / $ 4 ( ' S
Sefe-e -cio 1 / -2 -
Th pli ,ion Becomes Your Building Permit en A pproved
i g Paid / eCelpl �Io. �. �
Date B i /��JJ
4 24.- l o
l
Cuilding i ' . , Date
This is to c' tify that e request in the above application and accompanying document is in ccordance with the City Zoning Ordinance and may proceed as requested. This document
when sign / by the IN PI nner constitutes a temporary Certificate of Zoning compli ce a allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued. rI
. l II ■II a t 1
Planning Direc s 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
(I
PR! CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4 10
AND UTILITY CONNECTION PERMIT
- -... S��P I. White File
2. Pink City PERMIT NO.
3 Yellow Applicant 1O `} 36
I O J `� I
(Please type or print and sign at bolt m)
ADDRESS 6-6 / /7-4W:31/6-' 2 C4 a.. ZONING (office e)
r
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) A! i . (Phone)
(Address)
BUILDER //� _/'
(Company Name) ) i ��� Dc � ti5 (Phone) ( Q I Z 6% 665 z9
(Contact Name) /� A i-�\lv skJ 0 a� 'A
" (Phone) Cc
/
(Address) Z5 5 C 5/ 5'
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch DRe-Roofing ❑Re- Siding ❑Lower Level Finish El Fireplace
['Addition ['Alteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. XMisc. /O cel
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 I hav imished inf mation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
above -men • . .rope and that a onstruc will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official • : n revok thi ermit for jus ause. u thermore, I hereby agree that the city official or a designee may enter upon the property to perform needed 1 spections.
X 7 76 fi � 2
,
gnature Contractor's License No. Date
Perm' .7laluation 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 I $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ it 47'5
This Application Becomes Your Building Permit When Approved Paid II. 7l' Re e t No. G Olc Z..__
Date 4 ? .l 0' By
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
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 1-i71-/t9/c >R
TYPE OF WORK f/o
USE OF BUILDING /Z. /- ///L--
PERMIT NO. /4 , 0 DATE ISSUED 4% Z4. 1 a
BUILDER ()077)0 arc Oe'/ A/f PHONE # 4/2., r 2/ z1
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
4 1160 W ra 1 1
I FINAL 1 1
FOR ALL INSPECTIONS (952) 447 -9850
• •
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
• INSPECTION
RECORD
SITE ADDRESS 5 6 , i 2 µE,
TYPE OF WORK Pct G. ��., Er�5
USE OF BUILDING Res /
PERMIT NO. DATE ISSUED 4 /z o
BUILDER �Az4L -st- PHONE # q z - S7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
FOOTING pftov L- o����T1oN k=Ro� pit, To ros
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
1 4100141,- AN UN>61- Srljc4-,AnZ, 1(6? -& LA &c c, Pekm t r k s (2 I
I FINAL 1 1
FOR ALL INSPECTIONS (952) 447 -9850
•