HomeMy WebLinkAboutBuilding Permit 12.460 J
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o c PRlp CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
F ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 5
U x
rsi AND UTILITY CONNECTION PERMIT Z ° 1a.
��NN ESO�� I. White File
C
?. Pink City PERMIT NO. /2 4.6 to
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
ZONING (office use)
/(6 #6 6C L QA/
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) 61/44.45 i� i / 5� 36_,-;/
(Phone) 'IV&
'/ / -�
(Address) 161,11, ( oloA f . /Le, Pit o { f`e' .
BUILDER `
(Company Name) ( ''v€ " f 0)16/1 1 G h L (Phone) '(C 2J2 (ieW
(Contact Name) _ ' e V6t tft- (Phone)
(Address) (cc dot ( / /7
IC / ve
too - ' l / e " 556 yb
TYPE OF WORK ❑ New Construction Deck ❑Porch Eke-Roofing ❑Re- Siding ['Lower Level Finish 1:1 Fireplace
EAddition ❑Alte anon ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5 i
hereby certify that I have furnished 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 .roperty 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 revo this permit forju cause Fu i . I hereby agree that the city official or a designee ay enter upon the property to perform needed inspections.
X mit....,
6 2.1 — r
Signature Contractor's License No. Date
Permit Valuation '3 o oc 00 Park Support Fee # $
Permit Fee $ 8 a . 6' SAC # $
Plan Check Fee $ 57. 3 62 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 $ /4'7- /1
This Ap at i Becomes Yo` Building Permit When pp ved Paid / 4 - 7, 6 / eceipt No. (p ,j .5 ,
Date S 4-2..,s( Z,,.,
5
. Lidding Ufticla ate
This is to c • f fy th,, e request in tflrabove application and accompanying docum is is i accordance with the City Zoning Ordinance and may proceed as requested. This document
when si,n• i . th ••ty Planner constitutes a temporary Certificate of Zoning com iance d allows construction to commence. Before occupancy, a Certificate of Occupancy must he
issued t--
&1- ISA 2.A f
i, t • � .r Da - 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 M46 BE/V OA
TYPE OF WORK IDECIC
USE OF BUILDING Wept
PERMIT NO. /Z , 4-60 DATE ISSUED 5.2-l-12..
BUILDER P/Q' "A e 0 . PHONE # &'Z• 2J2. •
NOTE: THIS THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING Del` 1 5-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I MAMA 1 I I
FINAL 544
FOR ALL INSPECTIONS (952) 447 -9850