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HomeMy WebLinkAboutBuilding Permit 13. 0795 ) k IL j � � WW L § 2 -00 w z ® § 555 2 > o 2§§(0 0 2 .d ..‹. § 2 . w owwo . 2 z j 000000 > g 0 R / ' / CI w z p 2 / § ° 1 E e §§Lu ° § % w z ce 2 ?27 . §§ a Q 41 1 0 0 a �$b��% a f 2 2 ( §o® § §u c o 2 ® ) a2 i w w & w 000000 -- O0 � $ O. I re a 0 < k § \ « NC u • . w z o § P. 2 § ; � / 9. ® < - _ }/ § 2 < 0 Lu co 1- § c< 0 a- - ® z °���2 W w " 2 IL 0 W W W 0z■ 2aw a Ce � « o / � uj § k 0 ��� =L60 0 200 r," Q U? « 0 a 000040 Q O 0 / o PRI"6 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd (gI TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 4 :tivN E Soll' I. White City File Pi 2. Pink PERMIT NO. /3 _ 679 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS o S ZONING (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER ©Q ( .� 6J /' �(a n 7 95'2/ 82 6. 3/ � y (Name) (Phone) (Address) 5 L (� f C ( ( < 0 S Z� 1 Az0 r l, J 1 np C (4 S BUILDER (Company Name) THD At- Home Service, Inc 2690 Cumberland Pkwy, Ste 300 (Phone) (Contact Name) Atlanta, GA 30339 -3913 (Phone) ? V • G ° y7 (Address) Lic # CR268257 Ph. 763/542 -8826 Jo Cl TYPE OF WORK 0 New Construction ['Deck ❑Porch DRe- Roofing 'e- Siding ❑Lower Level Finish D Fireplace ❑Addition ❑Alteration ❑Utility Connection r e , i c/, n ` ? 4 m mi. CODE: ❑I.R.C. DI.B.C. 0 Misc. Type of Construction: I II III IV V A B PROJECT COST /VALUE $ / / Z 7 7 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 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 can revoke this permit for ust use Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. ,/ C � L 2S7 7Il 4( /3 Signature Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $ SAC # $ Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $ State Surcharge $ 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 $ This Application Becomes Your Building Permit When Approved Paid 7 7S Recei 4 9 3 Date l / )3//3 By / Building Official Date 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 Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Cate icate 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 Prior Lake, MN 55372