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HomeMy WebLinkAboutBuilding Permit 11. 1091 J W Z I J O Z u. ft \ IL Z WWa 0 14 4 ►W. �7 , � Le 1 ooaoo > c l z W = cc N u . W .� Z _ 0 0< co o W co 4/ m tu • -,Q „It • $ U a OD a 0 z a. _ yj _11UL O O Z F.. C a w w w w 14 ■%; 000000 O O w w a a LL H iu W \` O- J W re iu et — .° 5 P ill 0 q a c; F u Q o► o z O Q S U N N n OC • \ O ( 7 ~C9H a Z S V V d - N Z ZOZ Z W y W J W �[ I i J q 0W w W Z i O V V a 0 0 UU.UU.U. 0 3 v 0 0z a 0 a 000000 0 0 ❑ 5 I. c o PRi0 CITY OF PRIOR LAKE BUILDING PERMIT, / + Date Rec'd .1.0 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE v AND UTILITY CONNECTION PERMIT 'd jkN ESO " I. White File ^/.' z. Pink City (`a y PERMIT NO. // 1 1 f, 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) l 6C80 L. W. , _-) • 1 e ME- LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) x C ` � (Phone) (Address) N b `© UJ & - - - 4 I 'R--D (12._._ '� BUILDER (Company Name) P -01 MI C.)\ L`-' f ' (Phone) (Contact Name) (Phone) L l ' 2 S q 6 (s, (Address) [—}Y 1.6 -C )+ /, '" AVG il . 1 . -ice L. TYPE OF WORK ❑ New Construction ['Deck ❑Porch ''Re- Roofing ❑Re- Siding DLower Level Finish ❑ Fireplace DAddition DAlteration DUtility Conne tion CODE: ❑I,R.C. ❑I.B.C. ❑ Misc. Type of Construction: I II III IV V AB PROJECT COST /VALUE $ e) G 00 • Occupancy Group: A B E F H I M R S U (excluding land) 1 Division: 1 2 3 4 5 I hereby certify • t 1 have famished 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 - mennone . property and that all construction 11 conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can rev • this permit for Just , I hereby agree that the city official or a designee may enter upon the property to perform needed nspection . - gnature Contractor's License No. to 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 $ This Application Becomes Your Building Permit When Approved Paid 19 l f R pt No. (/¢1 0 Date / /1 1 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