HomeMy WebLinkAboutBuilding Permit 13. 0803 (2) `A
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i i . " -- PR: CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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4t/A'NESdit. I. White File
2. Pink City PERMIT NO. / 3 .,
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS , ZONING (office use)
k 44St ' C-'r
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER -
(Name) J C ok + N /ia ve in e t'1/1 (Phone)
(Address)
BUILDER 1 n/I ` '
(Company Name) / t C _. (Phone) & �
(Contact Name) (CQ 11`10_ Ho% �C 7 (Phone) 6 ( Z sSd _g 2 -, 7
(Address) / 0 5 l /COS(' V`1O V 1/ l,[ t / (`_ Ic..5 1 �� �3/
TYPE OF WORK ❑ New Construcpon ['Deck ❑Poach [Me-Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
['Addition + Alteration ['Utility Connection
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CODE: DI.R.C. ❑I.B.C. Misc. �C pc't i'r' !i zi u 0/¢ C t' -
Type of Construction: I II III IV V A B
PROJECT COST /VALUE $ S 0 (.)C
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that 1 have fu• %shed information on thi• application which is to the best of my knowledge tine and correct. 1 also certify that I am the owner or authorized agent for the
above - mentioned propel , nd that all const tcti w 1 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 . . rmit for Just cause. Fu e' ore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
( X ` ` ISC 063 2as 7 - 2-Y` 73
\ \N„....)
Signature Contractor's License No. Date
Permit Valuation , Z604 --- Park Support Fee # $
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Permit Fee $ 1 - ' "1 SAC # $
Plan Check Fee $ 41 41 i. 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 I $ TOTAL DUE $ ( 'ZZ . 6?
This Appli • in 1 comes Youe Building Permit , en Appro ed Paid EZAMBRIIIII Recei. t o - ,3 •1�
I Date MEM B In
—�� 7 7 J NI `
• Bull int. . ' 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 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 Prior Lake, MN 55372
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CITY OF, OR _ AKE •
1N$PECTOR . 1
DATE . N PERMIT T.
M ACCEPTED AS SUBMITTED
ACCEPTED WITH CORRECTIONS AS NOTED
0 NOT ACCEPTED - CORRECT & RESUBMIT
Tune comments are for your information. AN work shall be done
in 111N compliance with aN appNcable building & zoning cods
mquflms.Ks includig Hems not sp.GNcallynolsd in this rev sw.
KEEP THIS PLAN SET ON SITE AT ALL TIMES
3NAJ RoMq O YTIO
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:, rRIOR LAm, DEPARTMENT OF
BUILDING AND INSPECTION
RECORD
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: SITE ADDRESS ( 44 Db\i` '
TYPE OF WORK R "',9-(/ * ' °'I' i'�-o A
USE OF BUILDING
PERMIT NO. / 1 3-8(72- � j
DATE ISSUED 7
(6
BUILDER &t,' ."( PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I j v 1 1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FRAMING hca�, / 1 1 1
FINAL - 1 k \ ,- 1 1
F :
FOR ALL INSPECTIONS (952) 447 -9850