HomeMy WebLinkAboutBuilding Permit 13. 1021 —
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Nieman Roofing Co., Inc. 952 - 758 -5112 p.2 I.rLII
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o� PR D� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�;.
r' , / 1I `� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
\ .,, ' AND UTILITY CONNECTION PERMIT
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2. Pink city PERMIT NO. \ 3 i 0 - L S
3. Yellow Applicant
(Please type or print and sign at bottom) I ZONING (office use)
ADDRESS y }�,
[p f /f /l js /!S f / r'� /19 i ' l 2i t�t AVe P' f i b 5` Lo PIN/ N/ i
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PLC)
j " � tkrrz 1?� /,.� e
OWNER _. e m r /e e (Phone) o� � 7 � 5 �1
(Name)bAvP ,tea 1 in 6 re :elf' (} (Address) /t l /J; I G //S 1 �/'7 l r1 4 u e P i n c. Z. e m V BUILDER ` /� C� r / Tn c. (Phone) 6 %5 a - 75: •1 f
(Company Name) N irn frY rC nr�� ri J o �� ° r t
(Contact Name) `7rN (Phone)
A t (Address) 0 4r, �i / f v c,Jrrt j"i\ N` �` (77 l
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TYPE OF WORK ❑ New Construction ODeck ❑Porch $te- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODEt DI.R.C. K ❑ Misc: ,B.C• oc7
Type of Construction: I II III 1V V A B
,
Occupancy Group: A BE F HI M R S U PROJECT COST /VALUE $ C (J ()?) —
(excluding land)
Division: 1 2 3 4
1 hereby certify that 1 have furnished inforrnation on this application which is to the best of my knowtedge true and correct. I also certify that I am the owner or authorized agent for the
above - mentioned property and that all construction will :onform to all existing state and local laws and proceed accordance with
e needed inspa aware that the building
official can xoke this permit for just cause_ Furthermore, I hereby agree that the city official of a designee may upon the property in P de ns -1.3
X t y `'' -------M Contractor's License No. Date
Signature
� q Park Support Fee # $
Permit Valuation ` l t 600
, ' # $
Permit Fee $ e)73 .71- SAC
Plan Check Fee $ 431 -14 Water Meter Size 5/8 "; 1 "; $
$
State Surcharge Pressure Reducer
Penalty ' $ Sewer /Water Connection Fee # $
Water Tower Fee
Plumbing Permit Fee $ $
$
Mechanical Permit Fee $ Builder's Deposit
Other Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $ TOTAL DUE �{t 3 $
$ (13c0.‘1
cued ' Pai 3 . Recei . ,•�1 r
This A r 'mum Becomes Your Building Permit " ". 1�
Date �1 B
: uL, in f fieiaf —1■ Date
1
when signed by the City Pl on titutes a tempo ary Certificate cf compli and allows ws m tructionn toty comm Zoning Ordinance
Before and
cupancy proceed requested. t
Certificate Occupancy muscbe
issued.
Planning Director
Date Special Conditions, if any
24 Lour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
46445 Dakota Street S.E., Prior Lake, Minnesota 55372
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PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS v
TYPE OF WORK
USE OF BUILDING c (
z- � `� 1\1 t t
PERMIT NO. c - to DATE ISSUED
BUILDER t6-M - �e , PHONE # W Z -1 47 c
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I � I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FINAL %; 1 - y-/ 1
l
FOR ALL INSPECTIONS (952) 447 - 9850