HomeMy WebLinkAboutBuilding Permit 12.842 (! J F ,.,
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4, 'F2I CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT //_ lZ
I. White File PERMIT NO . jJ �� �,p
3 . Pink City / � ✓ (./ `J
3. Yellow Applicant ` E34 z
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/0 ‘I/i A Pf4 /2, icv- .
LEGAL DESCRIPTION (office use only) �I /
LOT i BLOCK 3 ADDITION 54. fiS D f / `-47 fit i. 6 P11:21 ..S 2Zr- 0
OWNER .„....--- ]�/ / /$5 �,-'' / G Z �/
(Name) / ..0 /•1 'G /C� , ; hWj #?r.._ (Phone) '� 1 �' �7 — PS - 6
(Address) 1 8 7 7 f/' 1.4..✓ Z .4"✓ !" /t n /--. Z—G 4 .C._ s'I.
BUILDER / /10" u �
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(Company Name) I-<` d'o � - ( t ' (Phone) 95 ` - `�/
(Contact Name) ' "- I-411 ! / OA j 5 (Phone) ,2 — 4(69- � �
(Address) X76 y7 (it 00: fiG► I (l e / 3 L s-i* AA -‘"5"
TYPE OF WORK ❑ New Construction eck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
['Addition ❑Alteratio ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Mis&
Type of Construction: I II III IV V A B 2
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished informati. • 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 con Ilion 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 revoke this . - . ' • , ca .- urthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X 1 � ''''' # ,&.y 7074— z
Signature Contractor's License No. Date
Permit Valuation 2, 0 00- / 1/ , Park Support Fee # $
Permit Fee $ 23. 7 3 -- SAC # $
Plan Check Fee $ 4 q ¢ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ j U 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 $ /a2- . C C
This A�jj' ti. Becomes Your Building Permit When Apt ove' w3,,t. Da e Y Receipt_ O. jl U V l — g L J By , i
I
:=i ldin z Official P ate
This is to certi i at e est in the above application and accompanying documents is in ace rdan• - with the City Zoning Ordinance and may proceed as requested. This document
when signed s / /the IV ty nner constitutes a temporary Certificate of Zoning compliance and . low. construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
8 /
Planning Director Da Special Conditions, if any
4 hour no ice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
PRIOR LAKE BUILD AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS /
TYPE OF WORK I
USE OF BUILDING 2 A,
PERMIT NO. •Agiur IDATE ISSUED
BUILDER may? _ •• PHONE # Q
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSVECf�� I � /' � ••v
I FOOTING 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN S l GNED
I artaari 1 1
(FINAL Sec tfen.4 4;(, (2 -e(sA
FOR ALL INSPECTIONS (952) 447 -9850