HomeMy WebLinkAboutBuilding Permit 12.1404 J E.
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of PRi CITY OF PRIOR LAKE BUILDING PERMIT, Date Reed o TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /, 2 j! r2_,- G
.. x
x AND UTILITY CONNECTION PERMIT
v
44NesoiR 1. White File
2 PERMIT NO . . Pink City /J 4 -0
3 Yellow Applicant { �. i [ /
/ �/
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
( ?7 (>/lib taw ,/ 4)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) C � 41-t `e3 (Phone)
(Address)
BUILDER -- / /- p r
(Company Name) fot.l1J tt C`� C -c. i IAA/ (Phone) C� 12- v �0 `3 ?9j 7
i
(Contact Name) '� -�ri-1 1 yet - -' (Phone)
(Address) /(�7J( 7 4 L , / k Lai /'L,( A6,, C /1-1c 714 w 112 Z
TYPE OF WORK 0 New Constructs ❑Deck [Porch DRe- Roofing ['Re-Siding ❑Lower Level Finish 0 Fireplace
['Addition Alteration ❑Utility Connection /
CODE: ❑LR.C. ❑LB.C. ® Mist W 10 DOW c O pci- i____
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ _-2-9
Division: 1 2 3 4 5
(excluding land)
1 I hereby certify that t 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 can revoke this .. - s just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X / .f► _ G CIS We 3 i/ /z
-i • e Contractor's License No. Date
Permit Valuation 1...e.4-L O Sett Park Support Fee # $
Permit Fee $ (111, -
( SAC # $
Plan Check Fee $ 1 i Water Meter Size 5/8 "; I "; $
State Surcharge $ Z.. , 5° Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ ,—... ., Water Tower Fee # $
Mechanical Permit Fee 1 $ ,. -- 5 Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE �i k 1412A ( $ 257 if.
P `
This App ati Becomes Your Building Permit en A proved Paid S/ _ Z 9 Rece' No 4977 -
Date `/. % B
tt Z q ( z
u e • . Date
This is to ce • fy tha the request in the above application and accompanying doc ments '. in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signe./�,y he Planner constwxes a temporary Certificate of Zoning mplia a and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued. .
?
A. t Z (1
r ' annin:: e j ate Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
P R I R LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 027 M aniti0oD go.
NATURE OF WORK .S
USE OF BUILDING a it Ir..
PERMIT NO. 1 Z . DATc ISSUED 11 Z7. /Z...
CONTRACTOR d L5 7 ' dill me. PHONE Gn i. 111107. 37'7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
1 1
1 1
PLACE NO CONCRETE NTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION , /
ELECTRICAL
HEATING (if required)
1111111111111111111GN UNE .
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 1
FINALS
BUILDING 2
ELECTRICAL
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough -in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447 -9850
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