HomeMy WebLinkAboutBuilding Permit 10. 0876 0 000000 7 0 > KB
/ 0 0 0 ■22 -n 32 0 2 0 m
§ 0 a xx C � /§ Z -4 z X k _
1 71 m m- m k ae \� 03
\ • _ z
% ® D 0 � E
\ 2 2 z m m
0 > z q
-I -n - \
4, m -n 0 0 000000
Z m / ������
rrl
E
01)
\ q t §§ x m x 71 0 k, @
-o _ @ m o 0
\ CI) i m o ■ a r m W
0 SI 0 . r -n \\ 73 -1 P o
q
0 z > c c P m
0 2 m
0
\ \ m -. v.
\ 0 00000 L.' o
\ 2 2 . ?2I -
0 Eq -0 -0® \
-
R. k Kk %� \®
4 � m m � �
F
j / f k
- h -4 r. 0
of PeI CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /b d
IN x AND UTILITY CONNECTION PERMIT
A'_n'NESO I. white File /
2. Pink City 0 7 0
PERMIT NO ////
3 Yellow Applicant f
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
1 (p 0 Lo / '6"_ /,/ (h/ .
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) 'J 6 0 frt_i 1,1 (Phone)
ej (Address) �� jQ r !'t ft re F c �-
� 1 1 �� P/�'( e ��
BUILDER / P / (� ,
(Company Name) l /1 A � T 1) - t g .... (Phone) Q'c5�r� ' � 9 a '
p y f f r L � (Contact Name) q � � (Phone) 4V,; s - 73
+ QQ --
(Address) 3l p.�O 1j i 6,,,a., � jeir CJ► � /1 Cl A i I41e ) O S3.�Z
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e- Roofing ['Re-Siding ['Lower Level Finish ❑ Fireplace
['Addition ['Alteration ['Utility Conne to
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U
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 1 am the owner or authorized agent for the
above - mentioned property and that all construction will conform to a • xisting state and local laws and will proceed in accordance with submitted plans. I am aware that the building
offici.y an revoke t h permit for just cause. Furthermore I hereby . - that the ci official or a designee may enter upon the property to perform needed inspections.
* ' 0 n / � iii1 � D J — ./ /l�
ignature Contractor's License No, Da e
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 $ '7g 75
This Application Be 'ill s Your Building Permit When Approved Paid f • 7 Rec No. 6 / -4I
y d Date /6. 4. /0 By
/o . ¢
Building . ticial Date
This is to certify that t 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