HomeMy WebLinkAboutBuilding Permit 13. 1021 J
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Nieman Roofing Co., Inc. 952 -758 -5112 p.2 Wu
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o PR /04, CITY OF PRIOR LAKE BUILDING PERMIT,
Date Recd
1 ' TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
q / �. ; AND UTILITY CONNECTION PERMIT
1. white F I PERMIT 1110. o �1
2. Pink City ! \ i
3. Yellow A pplican;
(Please type or print and sign at bottom) 1 ZONING (office use)
ADDRESS 1 _ . !1� to / & ! /l /(o / /S" / - I/ 7 2t Yl AVe 6 n c
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
1) r�J 2. l�D s?
(Name) _. e n� 1► - . (Phon 2 7��?,S
(Name) r S ' o l - -- • 6.. Y.! 3 n j�
(Address) / /ii; l t, / /S l4I /') /� rti n / Q . Tr i /n a -c� �� f
BUILDER a f1 p n f n C , (Phone) g5 0? " 9:-SS ` I f 7 /.�
(Company Name) l ira r11� -n !1J
(Contact Name) (
.�. (Phone)
- I ` �
(Address) ,, L• _ I 1
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TYPE OF WORK ❑ New Construction ❑Deck ❑Porch Re- Roofing []Re- Siding LJLower Level Finish ❑ Fireplace
['Addition ❑Alteration ❑Utility Connection
CODE []LR.C. ZI ❑ mi.: : i.S.C. ,, ff o0
Type of Construction: A B E F 11 I MR S U PROJECT COST/VALUE $ 7 �, (�( <•
Occupancy Group: 1 2 3 4 5 (excluding land)
Division:
I heteby certify that 1 have furnished information on this application which is to the best any knowledge nut and correct. I also certify that I 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 pr fee i oedance with e mit ted neede . 1 am are that the building
official revoke this permit for just cause_ Furthermore, I hereby agree that the city official or a design Y up property P
/
X P ',` � �a�_
Contrac License No. Date
Signature e
Park Support Fee # $
Permit Valuation 41 # $
Permit Fee $ vZ3.7s SAC
Plan Check Fee $ L�7� "j •- 1 4 Water Meter Size 5/8 "; 1 "; $
$
State Surcharge $ �v , Pressure Reducer
Penalty , $ Sewer /Water Connection Fee # $
Water Tower Fee #
Plumbing Permit Fee $
Mechanical Permit Fee $ Builder's Deposit
Other $
Sewer & Water Permit Fee $
$ t
Gas Fireplace Permit Pee $ TOTAL DUE $
n 3 $ 3('
cued Paid 1 � Recei r ��� . • �i 7
This A eat . , Becomes Your Building remit " Date '1/�l B
I■
• Date
Alai.. in i fficiat —� ►�
i This is to certify that the request in the above application and accompanying documenu is in accordance with the City Zoning Ordinance and rnay proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate ct Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy mastic
issued.
Panning Director
Date Special Conditions, if any
24 hour notice for all inspections (452} - 9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS (cam \\ V(/k -cr i rtAKS
TYPE OF WORK
USE OF BUILDING Ic,
PERMIT NO. c; < DATE ISS ED 9 1\11'3
BUILDER t&--iv1 (. PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
IVOSE
1 1 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
*MIS 1k)5 ‹ice 1 1
FINAL W d�
FOR ALL INSPECTIONS (952) 447 -9850