HomeMy WebLinkAboutBuilding Permit 13. 0757 0 -1 1 ..,
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,yo Yltp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
ti 1 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 7. 5. J
� ?
t ' AND UTILITY CONNECTION PERMIT /
I. wait. City , i
2 Pink C PERMIT NO. l - 1 ✓ .
3 Yellow Appheent
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
`139i Da -1 o.. &t. 5 E Pr;or L11.1.(G
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) Y D wt 1? 49 a >F z (Phone) 9Sd - `/9'7 - 3 a.7/
(Address) 43 9/ (7 et Ilo d-e t 3t S E - t 6 r la
BUILDER
(Company Name) M p /lo ( /4 64) k4 c r5 .Lr (Phone) 9SQL --• 7' /_ /
7/ 7 -- ck 7t P
(Contact Name) J / e r e i... (Phone) 6 12 . 3 L 4-- 6-84/
(Address) 74' 7 7 /3) tit:: .51 , w .Six. V aj e. , /4/ */ S.5 7 8
TYPE OF WORK ❑ New Construction [Week ['Porch [Me-Roofing ❑Residing DLower Level Finish ❑ Fireplace
❑Addition ❑Alteration ['Utility Connection
CODE: Co I. .C. ❑LB.C. 1' - , . , -
Type of ntctnst Lion: I II III IV V A B
Occupancy Group: A B E F A I M R S U PROJECT COST /VALUE $ ta, 000 . 0o
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have famished 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 m all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke this permit for jyst use. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X V / / el /Gg w.r P _ RC" d o 2 35 yL 7 / /5I/ 3
Signature Contractor's License No. Date
Permit Valuation
G ° -
Park Support Fee # $
Permit Fee $ (31.571 SAC # $
Plan Check Fee $ .. ((3 Water Meter Size 5/8 "; 1 "; $
State Surcharge $
5. - Prentice 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 $ 2-2.4 . 3
This Application : ... • Your Building Permit Wh . Appro d Paid 2- Z J. G7 Receip o. 6 q 1 '/°'/ Z_
fj
r Date 7 l J e Q By Or
/ .;.
_________Iil fin Official -- --►,a
This is to certify that the 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 Cemficate 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 S.E., Prior Lake, Minnesota 55372
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 4°[ 1 T t
TYPE OF WORK (2___
USE OF BUILDING A
PERMIT NO. D ATE ISSUED 7 1 e ir
BUILDER Do( PHONE # 5 31
NOTE: THIS IS NOT 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
FPRA MI N& - 1 1
IFINAL 1 _, 1 q{ -y -,
FOR ALL INSPECTIONS (952) 447 - 9850