HomeMy WebLinkAboutBuilding Permit 12.299 • J
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of PR / CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 9. f
AND UTILITY CONNECTION PERMIT
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���A'NESO�P 2 Piin �;�,• PERMI NO. ! a , 2)7V
3 Yellow Applicant / /
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/642 7 kL,al 0
LEGAL DESCRIPTION (office use only) n
LOT2 BLOCK y ADDITION No ' 1 oh• ,IJ� J J L is PID
NER /
OW �
(Name) f e Id Ste-- A /y / ) (Phone) 6f2 - Z -7 71'
(Address) � / yy- JuAi i A i S)-e_ 1 3 r (,.462- ,' & AlAr `S 5"aYV
BUILDER
(Company Name) is (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. ❑ Misc. .
Type of Construction: I II III IV V A B
Occupancy Group: A B E F III MR S U PROJECT COST /VALUE $
Division: 1 2 3 4 5 (excluding land)
1 hereby certify that 1 have furnished information on this application which is to the hest of my knowledge true and correct. 1 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
otli' n.�n rev kc this permit for) . an Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed ins cello
X , \ �C— 1.5J S i 1 ( P Y j ! ? % 'L..
Signatur ' Contractor's License No. , to
Permit Valuation Park Support Fee # $
Permit Fee $ A3 '..Z5 SAC # $
Plan Check Fee $ 5 7• Water Meter Size 5/8 "; 1 $
State Surcharge $ ( 5" c:› 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
This A fTrca ion s cons .Your Banding Permit When ppr. ed Paid /4 2 G Rece t No. 69 �( j
A. at � 0 1 c 1"2- Date Q - 3. ! -- B
Building Official �� ate
This is to c fy that t . r quest i e above application and accompanying documen is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sig • by he CI '' an s - -- • •racy Certificate of Zoning ompii nce and allows construction to commence. Before occupancy, a Cotificate of Occupancy must be
issued / f(
. , / � 4 LL —roar 4f ('' (Z/
Plannin Bice • 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 // +6. ' /&2
TYPE OF WORK
USE OF BUILDING
PERMIT NO. _ . DATE ISSUED
BUILDER
�� - � � PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
PECTOR DATE
IF 1 1
PLACE NO CONCRETE UNTIL A OVE HAS BEEN SIGNED
1
FINAL 1 1 � (0 l
I fs,lk 1
FOR ALL INSPECTIONS (952) 447 - 9850