HomeMy WebLinkAboutBuilding Permit 12.609 (**---
PRI -- CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / / /5 �/2__ ,. AND UTILITY CONNECTION PERMIT Y
U t r j
40/PIE i White File
2 Pink City PERMIT NO. / (l�0
.
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office se)
( L OC — ()M 7
LEGAL DESCRIPTION (office use only)
LOT -� BLOCK C ADDITION Q �L H7 a C re,ey PID
OWNER
(Name) 1/VI A - Fi.4C“Cre-- (Phone) OS 4 2
(Address) 14 8E S 44k9L6 re L--
BUILDER
(Company Name) itrikc •V D r- c-0tA) CO (Phone) Cl 2- F6,I- J2
3ZS
(Contact Name) 1,Al2-IN ! v JS (Phone) (1Z' ' 3 -R162 y
(Address) # 76 p( ST e 5 J f.tCN�(6-1- > ( 'Z
TYPE OF WORK ❑ New Construction Ikleck ` ❑Porch ❑Re- Roofing ERe-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition EAlteration ❑Utility Connection
CODE: [LR.C. ❑I.B.C. El Misc.
Type of Construction: I II HI IV V A B q
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ t0 ` W
(excluding land)
Division: 1 2 3 4 5
I hereby certify that 1 have furnished information on this .placation 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 th .11 construction wi 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 • lust cause F ■ her ore I 1 -reby agree that the city official or a designee may enter upon the property to perform needed inspe lions. x I.v 41 .ta.0 -O L( (C 69 /! SI ( 2
ignature Contractor's License No. Date
Permit Valuation 3� d dC7. OD Park Support Fee # $
Permit Fee $ e 2-' SAC # $
Plan Check Fee $ 57. 30 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 i i\rui ( I it/ $ / 4 7. / /
This • . ica o Becomes Your Buildin& rmit n Appr ved Paid / 7. C / 66? Z-
111 / ►�' (D t0 Date 6w II. (Z�-
i iiik _ ate
This is to cert) hat th Vi ucst in the above ap and accompanying docume s is in accor• nee with the City Zoning Ordinance and may proceed as requested. This document
when signe e Cit P nner constitutes a temporary Certificate of Zoning comp ancc and at ws construction to commence. Before occupancy, a Certificate of Occupancy must be •
issued /
• r P •nning Director Date Special Conditions, if any
2• our notice for all i spections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
PRIOR LAKE BUILDING AND ONSPECTION
INSPECTION
RECORD
SITE ADDRESS /4f5 MAPLFi I�"r+�`
TYPE OF WORK OFig..
USE OF BUILDING geT A*
PERMIT NO. IZ � 609 DATE ISSUED G. IS. rL
BUILDER /��/mroiseX. PHONE # &/L, $41, 3SZS
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INS INSPECTOR DATE
FOOTING LJ c 1 G a/1/2- 1
PLACE NO CONCRETE UNTIL AB VE HAS BEEN SIGNED
I FRAMING
FINAL 1
FOR ALL INSPECTIONS (952) 447 -9850