HomeMy WebLinkAboutBuilding Permit 13. 0848 J
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o f PIO% CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE " , /3
.. ) AND UTILITY CONNECTION PERMIT
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: &;;k I. White File
2. pint: city PERMIT NO. /� /��
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3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
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3 .? L- P a s ri m,.. Co.....4 -- erN o e L°J(C- n., r.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER I
(Name) t he_: et-ve L1S (Phone)
(Address) 3 10 0 ` 3r C4- ,
BUILDER
(Company Name) /h eh- Cv►•d' tea.,, (Phone) to 1 Z ^ 1 Ito - jSZ .e _
(Contact Name) fl Igr1i 6 t ��ck ° e_ (Phone) i"\
(Address) 140"1 o , C444-e..... c : t .-c k f ' , L--. fi n ..'s 3 Z )
TYPE OF WORK ❑ New Construction j eck ❑Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
DAddition ❑Alteration ❑Utility Connection
CODE: I.R.C. ❑I.B.C. ❑ Misc.
0. T e of onstru ton: I II III IV V A B Q
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ ( i boa ,
(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 1 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 v ke this it for just cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Signature Contractor's License No, Date ,
Permit Valuation L.4 0 00A0 0 Park Support Fee # $
Permit Fee $ ‘ 6 3. OD SAC # $
Plan Check Fee $ V 6, co Water Meter Size 5/8 "; 1 "; $
State Surcharge $ 2• Q Q 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 efi 0 1 , ' $ i 7 ( .IDYD
This Apy a I % P Becomes Your Building Permit Whe Ap oved Paid / 7 . — cei p t No. 6 l..
Date (E° .13 Y
•uil 1 _ - - cta ate
----------:> —
This is to certify t , t the reques jn the above application and accompanying docume is in cordance with the City Zoning Ordinance and may proceed as requested. This document
when sig by t . e ity Planner constitutes a temporary Certificate of Zoning coma ante d allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued A
a
' ,nning Direct ti<te 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 BUILDRNG A D.r, SPECTION
INSPECTION
RECORD
SITE ADDRESS 3 9+Z O BR.I EN CT
TYPE OF WORK E
USE OF BUILDING
PERMIT NO. 3. % DATE ISSUED 41
BUILDER r CO tTx . PHONE # G /I. � I � . 552¢
NOTE: THIS IS OT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING 1 *# 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
LFINAL
• FOR ALL INSPECTIONS (952) 447 -9850