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HomeMy WebLinkAboutBuilding Permit 11. 0564 u z 1U re § ,-- � eww 0 w N? a.,) -,... -- g555 z \ §� §w z « § e E SƒUO � 2 f b O000 a \ o R w I \� § m / S d § § < Ca { 0 § . z ■ Z g R § k 2 0 000< 0 0 § : 0 IJJ ` m 0 2 0 § aLL23IE a f z ® ® N §§I § §3 N. oo g R o a�2 f 0 0 W / § 000000 .Ilk b )) / / I a a ? u § z / \ \ � z o ' u, k �0 R $ 0 o § @ it 0 z oz S e «'• ~ / 2z o <o § 2 vi§ 0 - w a R 2 Z §2 _ ja- 2 k cc fx B <® 0 uj W m z RJC42z� 2 ) o 0 ]© § 0 § o ����� 0 5u 0 a az < 0 a 000000 0 \000 _ O PRjo+P CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Z c f` `i 2 Pink City ` ( AND UTILITY CONNECTION PERMIT U tr1 I. white File I PERMIT NO . / / („4, Ar iNNES oit* ` 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 7 / 4 1 c 2 Z RC)/13)0 , . . k J LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER —, (Phone) (Name) I Sc 1 ot, rs. (Address) Zw c G BUILDER i '° ,2 . J e (Phone) qS ,� — Z 7o-7 / (Company Name)' c� ...a. t ' ' (Contact Name) // (Phone) (Address) 7 </ U � � J ��uYh.v/ ��� /?+ l'� G / V TYPE OF WORK ❑ New Construction ['Deck [Porch Pi ; e- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ❑Addition ['Alteration ❑Utility Conn. ction ❑ Misc. CODE: ❑I.R.C. ❑I•B•C• Type of Construction: I II HI IV V AB PROJECT COST /VALUE $ Occupancy Group: A B E F HI MR S U (excluding land) Division: 1 2 3 4 5 ' 1 hereby certify that 1 have furnished information on this application which is tb pfre best of my knowledge true and correct. 1 also certify that I am the owner or authorized agent for the above - mentioned proptrty and that all construct. will conform to all exi n state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can re oke this permit for just cause' ermore, I hereby agree a he city official or a designee may enter upon the property to perform needed inspections. . . 2.. � 6 $�� 7 6� -i'� Signature X — Contractor's License No. Date Permit V,. • ation 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 1 $ TOTAL DUE $ 799'' 7 // This Application Becomes Your Building Permit When Approved Paid i Re pt No. 3/7 1 Date & 74,// 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