HomeMy WebLinkAboutBuilding Permit 11. 121 J
O Zi
v
AQ � aL x ui
t ) 6 < z k.
N '-('')
0 gw w 'o 0 ��
N 000000 E. >
--,....r. _ ! o
w =
ce 2 N p
W es �_' J y
O j '< 4 m c 0 QC
O r iY 08U J O U 0 W
< ir. ` w
O z w m � • % w w 0
N U G. xzw N z
� , „ la 4 j p j W ' W W W X
l aXs C � t w o w x w cy
000000 -! p a o z
w
P..044 a a u YV = ) 1:::
x V Oo c
O < O on P 13
~ O (A 0 u. o� D pi
ap co
i p zaio N Z o �� W
u.v w w F- pY .Td[ � J .E ' Z ooCC�Z 2 —\ _ O O p v C�
L y c O u. u. u. F. p i r 3 c� c�
0Z a O a 000000 t) _
( c — PRI --- 0 � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �.
&' x AND UTILITY CONNECTION PERMIT 2 . 2 3. 1 /
U rgl
MiN'N I. white File PERMIT NO . /// /` /
3 Pink City / / /
3 Yellow Applicant f ( /
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/5Z2_1- m// w4y 17 .
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER / � t! / ,Q e/Cl J A99,1 0 V / - 5 6 / 2- e6 S y, 0 a (Name) !�' (Phone)
(Address) 1S2 Z if �4t/c° Wd y 7 /6/ €'
�D AI till Pc 9
O c 6 ,,C. r, 3v
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ['Deck EPorch [Me- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
❑Addition ['Alteration OUtility Connection
CODE: ❑LR.C. I.B.C. ❑
XMisc. ,571 10/V/i
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $
Division: 1 2 3 4 5 (excluding land)
I
1 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 al -. stru on will co s 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 permit fo t cau urthermo he by agree that the city official or a designee may enter upon the property to perform needed inspections.
' Signaturr Contractor's License No. Date
Permit Valuation 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 $ 4 1, '7-5- This Application Becomes Your Building Permit When Approved Paid 41 , 7� Re eipt No. V 7/0 ti
Date Z , I B
Building 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 BUP DRNG D�NSPECTION
INSPECTION
RECORD
SITE ADDRESS /S ZZ 4- F/9/izbvm,
TYPE OF WORK SH v�m`
USE OF BUILDING
PERMIT NO. 1 I - I Z I DATE ISSUED Z _ /
BUILDER /95f1 /C.&J✓/Il PHONE # 065% Hap
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
hesswaa 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING wt- 1 NB 2izS(„ 1 1
IFINAL
FOR ALL INSPECTIONS (952) 447 -9850