HomeMy WebLinkAboutBuilding Permit 12.754 of P141p CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
A.
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE � , /6.. / L
AND UTILITY CONNECTION PERMIT
U ri
V' kNE SO 4�' I. white File PERMIT NO .
2. Pink City ?
3 Yellow Applicant /Z C ��
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
3 SVeA ,ee. 7 4 /L. 5.0
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER L.
(Name) AZ6 1 y sA/ i& (Phone) 952- {7" 8$0 1
(Address) 34/83 S )/ Jpe E- 7E. S. 7 4,1 .
( Comp nyy Name) /*7T PA-E/T Al / /issv a , ... (Phone) ICZ 4067 ^ O7 Zo
(Contact Name) NA (Phone)
(Address) 435 / 7)6' sr. l- . Ptoe, L44, MAJ . 553 72
TYPE OF WORK ❑ New Construction ❑Deck ['Porch ❑Re- Roofing DRe-Siding ❑Lower Level Finish ❑ Fireplace
['Addition ❑Alteration DUtility Connection p
CODE: I.R.C. ❑I.B.C. L �J Misc. /�4` 7 /�f�, /��c+4L
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 information 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 - 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
official rev • thi r . for just cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X L/- .i �► 7 7 -AD -/2._
Signature Contractor's License No. Date
Permit Valuation S- -- Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ 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
A-- $ � I s 1 S
This pli t O i r i Wililding Permit When ppro ed Paid 51- R ipt No. /�
• d _, Date Z ,. / �
1. , ?
. ' dim , 7" Dae
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 Cit Plan - constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued r .
V Plan — g 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 - 34S,rs
TYPE OF WORK •Oe.71p ate- PeeY+arA.Vut. (.c,,qs.c_
USE OF BUILDING 04 1/
PERMIT NO. 1c`1 ATE ISSUED 'Z�( 77-- ��P'
BUILDER f I'Y19N � � y�ocr , PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
(FINAL
FOR ALL INSPECTIONS (952) 447 -9850
( - 11
\\
•
•