HomeMy WebLinkAboutBuilding Permit 13. 1021 J
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Nieman Roofing Co., Inc. 952 -758 -5112 p•2 Wu
0 1-o ).--1 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
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\ . TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
.f I L � „ AND UTILITY CONNECTION PERMIT
t. Whim Fite PERMIT NO. 3 , -Lt
1. Pink City
3. Yellow A pplican:
(Please type or print and sign at bottom) l ZONING (office use)
ADDRESS LI
/ /// /( / /s , /(, // 7 Pt KI■ n e f l n �- 1� ke In1,f
1
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PM
�rZd2. I�olrrl e OWNER K Phone 95 XV 2 - �S `1
(N '1) Mo l'' rp — r��� tiEt� — c ri� <s �a ( )
(Address) f,1 /1; / 6, //S 16 11'7 /Y1 a � r+ f V G r in � -c� 1( e 'In /t;
BUILDER a ,t n v - n c (Phone) Q5 a _ / .S$ - 3/7
(Compang Name) Ake” rrr_n 614 11 J
(Contact Name) `7r, (Phone) •
(Address) t " !} 4r,,,k 1 v
P AL r0 PC/1 1" �P m 'NJ `c > (
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TYPE OF WORK 0 New Construction °Deck OPorch Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Firep]ace
['Addition DAlteration Elitility Connection
❑ Misc:
CODE: [}LR.C. �LB.C. 00
Type of Construction: I II III IV V A 13
Occupancy Group: A 13 E F Ii I M R S U PROJECT COST /VALUE $ C, n C 1
p
Division: I 2 3 4 5 (excluding land)
I beteby 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 ascot for the
above- me:ttioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with ib plans. ���wdte that the building
official can rgy'okve this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property P
X1."1. '`� Contractor License N Date
Signature ,
Permit Valuation 41 t WO, Park Support Fee # $
$
Permit Fee $ c 73 • , 7 S SAC
$
L7� Z • - 4 Water Meter Size 5/8 "; 1 "; $
Plan Check Fee $
State Surcharge $ 2-4 ., Pressure Reducer
Penal $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
$
Mechanical Permit Fee $ Builder's Deposit
-
Sewer & Water Permit Fee $ Other $
t
Gas Fireplace Permit Fee i $ TOTAL DUE OAI In i ( E (13‘0.11
This A v r - cat d.. Becomes Your Building Permit •' . , , oved Paid 3 .1 Recei f,„ . - QIT
Date lAf/�� B :/�
' ....64.- -tom Date ' .
s ni in ffteial 'min.,
i when signed by the City Pl constitutes a a tem � po ary Certificate cf oom ' and allows ws construction to�commn� Before and cupancy. a of Occupa mustbc
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
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PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS kt\ M /k - 1- rA
TYPE OF WORK.
USE OF BUILDING I C5 ,-
PERMIT NO. \Oz DATE ISS ED 9 ■1 1‘3
BUILDER PHONE # 416t I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
1
�,.. 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
*Mfg i /Q ,5 1 1
FINAL ��
FOR ALL INSPECTIONS (952) 447 -9850