HomeMy WebLinkAboutBuilding Permit 12.735 ( PRI CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
cn AND UTILITY CONNECTION PERMIT 7 6 .1Z'
NE Olt. I. White File
2. Pint; City PERMIT NO. / 1 735
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
y& Z o rrL= e s TPA r t S'I22 LAKE
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(N ame) O h& `Z r 1- L ii i1 Pc `a (Phone) teD 4 02 /1
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction Deck ❑Porch ❑Re- Roofing DRe-Siding DLower Level Finish ❑ Fireplace
DAddition ❑Alter io ['Utility Connection
CODE: DI.R.C. DI.B.C.
Misc. D A'Jb / -/L 6 N�
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 have furnished i. ormation on this application 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 -me . prope at. = c • truction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official c. e • ms , .ermit f. use Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed 1 spect ons.
X ( 76�t Z
Signature Contractor's License No. Date
Permit Valuation o U G Park Support Fee # $
Permit Fee $ 2.: --- p p SAC # $
Plan Check Fee $ Re 2_5 Water Meter Size 5/8 "; 1 "; $
State Surcharge $ J - i) 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 $ ¢/ _ 7
"'� 31
This Applicatio , Becomes Your Building Permit When Approved Paid 7 t ceipt No. 6
JP ' ____ 1,6_ii.._ Date 7 Ga . /Z
01"
me 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 BUILDING AND �NSPECTION
INSPECTION
RECORD
SITE ADDRESS /46, 72z-o 7 7 �� �L
TYPE OF WORK WiC41N6 L /2-tojie.wA162
USE OF BUILDING A nAG-
PERMIT NO. /Z - 735' DATE ISSUED 7- 6 •fZ_
BUILDER P2.0 PHONE# Si. (c ¢4 - 2 - ge
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW /
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
*NNW 1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FINAL I � � � 1(A2I 1 I
FOR ALL INSPECTIONS (952) 447 - 9850