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HomeMy WebLinkAboutBuilding Permit 09. 0325 5 0 0- n 000000 1) o a 5E c) n n $ 000 0 ■�2��� § 7 § 2q 0 0 At 2k m m n o • k r o o/ � � > §a Z- o d 2 k g 41 k -4 m 0 � ^ � � k 0 q .. Z o 2 7§ ' d O k m % 0 r \ ■ r 13 II rn 7 7 § i 0 00000 Q m mm ■� ■ § ■� o = s § § O C• 4 0C % )41 2 - z■ mom■ n % ■ § m f m -n to ■■ 2g § m o n % 0 k 0 � ' r § O O z B D (.1.1 ® 0 9 w >c� 2 K m ) > CC $ / 0 < X 0 a 0 1 o 00000 1 ‘11 C 4 5E B g2 2§§ v. g 0 ® W MME0 \ 0 {§ \ E 9 § m 53 �■ f 2 k§ 0 o f PRI0� O CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 6,. S' O U tvj M�NNEso I. White File PERMIT N wow 2. Pink City q r 3/ 5 3 Yellow Applicant (((///��� M (Please type or print and sign at bottom) 4 ... ADDRESS ZONING (office use) • / 7 to GI /U0tt.t. ras IAy S6 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID ,..\. O WNE C (Name) R J d- pL(U x_ a ✓vk Cr (Phone) 9 S " yy 7 - (o 1 T3 (Address) / 7 ( ( ( /r Cit- f tV) / ,56-, BUILDER (Company Name) (Phone) (Contact Name) (Phone) (Address) TYPE OF WORK ❑ New Construction ['Deck ❑Porch ❑Re- Roofing ['Re-Siding ElLower Level Finish ❑ Fireplace 4 ['Addition ['Alteration ❑Utility Connection CODE: .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 (excluding land) Division: 1 2 3 4 5 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 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 ino accordance with submitted plans. I am aware that the building 4 official can e his per mit or just ca e Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed mspections. Signature Contractor's License No, Date Permit Valuation `,' ® ©Q Park Support Fee # $ Permit Fee $ 8s vs- SAC # $ Plan Check Fee $ 5-1.34, Water Meter Size 5/8 "; 1 "; $ State Surcharge $ (• 50 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 $ ( 47 This A jc , s : ecomes Your Permit Building Peit • A l.. roved Paid 4 7- 11 G „5; a ReC pt No. /� Date � Building 0 ` • Dar This is to certify at tI • , quest in the above application and accompanying documen is in a ordance with the City Zoning Ordinance and may proceed as requested. This document when signe y e • ty 'Ian es a temporary Certificate of Zoning comp nce a allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. II/ Plan - 7 — ; 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 , DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS l /Ca ( e-t) TYPE OF WORK USE OF BUILDING C2-15 A- R— P ERMIT NO. en- 3 - DATE ISSUED Co O`� BUILDER "rcpt+ PHONE # 44- -co les NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPE DATE IFOOTJNG 1 Co .72/65 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGN IMMURING. I FINAL Pl 1 S -h FOR ALL INSPECTIONS (952) 447 - 9850