HomeMy WebLinkAboutBuilding Permit 12.1332 6 P R ./., p p CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
j ,,,,e- TEMPORARY CERTIFICATE OF ZONING COMPLIANCE //. (o 1 L
�` \' �' AND UTILITY CONNECTION PERMIT
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1. white File
2. Pink City PERMIT NO. /Z /33 Z.
3. Yellow Applicant i
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER 0
(Name) 7 4. n - ` l r c L 664' J (Phone)
(Address)
BUILDER
(Company Name) 0 eVc ^ (0 P 61c ( '- • ! •,r (Phone) 61 2 s 36 (- `'l 1 `( `l, A.'?
(Contact Nam 0'1 041.. Lev virn, (Phone)
(Address) 17 1 Z S icv..c i. Cr 1. , y t e U' 1 lam. yvv rNA S�` q q
TYPE OF WORK ❑ New Construction 0_4�neck DPorch DRe-Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
['Addition ❑Alter. ton DUtility Connection
CODE: ®I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III 1V V A B
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ - 2, Uv4._
Division: 1 2 3 4 5 (excluding land)
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 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 ., e this ••'t f.r just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
- 2.6 Il /C //Z
Signature Contractor's License No. Date
Permit Valuation 1 �) Z - So G Park Support Fee # $
44 Permit Fee $ 1' 1 9 ‘ 5 SAC # $
Plan Check Fee $ 140.5+ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ 2-50 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 6k '-i P (1, 4 f 1 Z $ 11(' .11
This A r licati. Becomes Your Building Permit en pproved Paid / 9t, 79 R ipt No. , 76 O,3
Date //1 Se"„ ( 2--
B i ilding O 7a-I __ Date
This is to c- . that •e request in the above application and accompanying d cements is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sip, - i. b the Planner constitutes a temporary Certificate of Zonin com ance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
1 _ A a b ( 1--
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. _ - Date Special Conditions, if any
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24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
PRIOR LAKE BUILDING AND ONSPECTION
INSPECTION
SITE ADDRESS 50015 RECORD
O E
TYPE OF WORK
USE OF BUILDING Nen/.
PERMIT NO /L 1332. DATE ISSUED 1/. %M. BUILDER DF�1N BW:L PHONE # WA. 41
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING 1 1 Via' kG4F4
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
Win 1 1
t FINAL 1 a I
FOR ALL INSPECTIONS (952) 447 •9850