HomeMy WebLinkAboutBuilding Permit 13. 0285 J
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OF PRtp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4.9, f Z
AND UTILITY CONNECTION PERMIT /
�
~I�NFSO I White File PERMIT NO . /3 z
2.. Pink City /
es t-
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS / l ZONING (office use)
1 YCQ S'it b l ;Ck_r" C r c . l� 5 o L Lie
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER f -- i
(Name) i ✓I'1 ' be ` b!� E- Ptck4- f5or7 (Phone)
(� f,
(Address) / 0 6 f b ri`c, r C i r Lvf I � ' c i '� R
1 BUILDER .
(Company Name) D e (p -r`� L C C, r f (Phone) 6 3 6 6 j ` �� U
/
(Contact Name) Chi 5 ' c t , o cV1 t%i ro (Phone) 6 6 12 7
(Address) 7375 /3J 4 Sef r. Ap f( t- Kitty ; M/V ) 3 / :
TYPE OF WORK 0 New Construction *D eck ❑Porch DRe- Roofing ORe- Siding ❑Lower Level Finish 0 Fireplace
DAddition DAlter. ion DUtility Connection
L
CODE: .R.C. DI.B.C. 0 Misc.
Type of C nstruction: I II III IV V AB CD O
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ 66 0
Division: 1 2 3 4 5
(excluding land)
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 pro •rty and that all cons ' ction 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 ke s per Just ca Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
X 3C 3 6 o 5 ( y -9 -(
Signature Contractor's License No. Date
Permit Valuation �� e d c) o o Park Support Fee # $
Permit Fee $ /0 3 U 6 SAC # $
Plan Check Fee $ 66 9s-. Water Meter Size 5/8 "; I"; $
State Surcharge $ Z ^ 6 d 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 $ ` 7 / _ ?�
r /y /
This ' ii, l ic in Becomes Your Building Permit . • n A proved Paid ,.. (1I . q Receipt No.. &S i + � ' R .. `1� Date I ( f f 3 By OA
`( j
` 1 uildin_ ttieial Date
This is to c • fy th tp' e request in the a. • • . • • ' anon and accompanying docum nts is n accordance with the City Zoning Ordinance and may proceed as requested. This document
when sigh* t (,F y Planner constitutes a temporary Certificate of Zoning co .liana and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
' 4f(f
Plan ' or 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 BUILDING D�INSPECTION
INSPECTION
RECORD
SITE ADDRESS j7 1"� �7 c-6 02 /2-'
TYPE OF WORK
USE OF BUILDING J! //
PERMIT NO. /3 Z SS DATE ISSUED 4- • 9 j
BUILDER DACP��7�/� PHONE # 6S! .36‘
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BEL
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
FOOTING 1 s- 13-- 13
PLACE NO CONCRETE UNTIL ABOVE HASYBEEN SIGNED
FINAL / ifG
FOR ALL INSPECTIONS (952) 447 -9850