HomeMy WebLinkAboutBuilding Permit 13. 0341 of PR /0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
3
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
en
y/NNesot� I white File pERMIT NO .
2
Pink City l � t 1
3 ^/�_ 1
Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/77)1 P r/3 k---1 F/ L7 4A'c P bp t ip •
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) / ) 7 , 4 , Z J L - / 1 ' Y ,...7 (Phone) 6/z--309-,2404-
(Address) /727/ /1/.44-3/4 ,e,¢vL pe/bi 44 /41
BUILDER I (Company Name) � OUi OD02 - J � DS v
/d'-1 Vie- (Phone) 9Y ? — y 7 9 /
/
(Contact Name) 7 7 cv" (Phone) 9J7 - Z Z - 6 Z
(Address) / 93// .5( 74'O 1 4e/. 0 LL L 5 3 7Z
TYPE OF WORK D New Construction week ❑Porch DRe- Roofing DRe- Siding ❑Lower Level Finish D Fireplace
DAddition DAlteration ❑Utility Connection
CODE: (t]t.R.C. DI.B.C. 0 Misc.
Type of Construction: I II III IV V AB PROJECT COST/ VALUE $ Gtr
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
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 all construction will conform 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 per - t for Just use Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspect ms- //
x eA337 71u //P
Signature Contractor's License No. Date
Permit Valuation (106'.- r Park Support Fee # $
Permit Fee $ /:� 4 SAC # $
Plan Check Fee $ ' l ` I T Water Meter size 5/8'• I"; _ $
State Surcharge $ G' , r 7 ' Pressure Reducer $
i 4'
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 $ t A
ThisApplii +n o •s Your Building Permit Wh• Approv• i Paid f L4 • . 4 Receipt Mc ' t! 1
i; _ Date 4--/z_„ 51 t 3 By .
Building Official D/ to
t�
This is to cc if that their uest in the above application and accompanying documents in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sign' , y th' it ° . ner constitutes a tem yraty Certificate of Zoning comptiame and all ws construction to commence- Before occupancy, a Certificate of Occupancy must be
issued
Planning 'i ate 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 11 zi C CI It_ 1:
TYPE OF WORK
USE OF BUILDING 47-
PERMIT NO. t DATE ISSUED 4 43
BUILDER 00 ir (96 r3 PHONE # 157 26 1 7 -6'z 3a
NOTE: THIS . IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I
FOOTING U‘-- 1 PR /5
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
1 1
FINAL 1 1 I
FOR ALL INSPECTIONS (952) 447 -9850