HomeMy WebLinkAboutBuilding Permit 13. 0973 J
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PR/ � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
J� \ TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
l ' II` / 3
.: AND UTILITY CONNECTION PERMIT
14N I. White File
pink City PERMIT NO /3 X 73
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
I / S IV.-le 5e Ci'rc. S Po
LEGAL DESCRIPTION (office use only) ,`
LOT 2-BLOCK ADDITION �Y7J)'l ° t _,� /A�� PID 035- `k T - 2 Y
OWNER
(Name) C ;41 kite> € (Phone) • (Address) t 7/ 3s Stv- ,c..��r6,- Ci SE
BUILDER _
(Company Name) P1 Dec h$ (Phone) ‘57- 39Y-2‘ 3 1
(Contact Name) 13i l F1 /f(,, (Phone) 4-51 3 q - i
(Address) LI 170 (.0 /oro,o 9-. >g Pie- L'cM AN
TYPE OF WORK ❑ New Construction RDeck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
['Addition ['Alteration ['Utility Connection
CODE: LR.C. ❑I.B.C. ❑ Misc. _ _
Type of Co truction: I II III IV V A B PROJECT COST /VALUE $ 6 OOG)
Occupancy Group: A B E F HI MR S U
(excluding land)
Division: 1 2 3 4 5
1 hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and correct. 1 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 proceed in accordance with submitted plans. I am aware that the building
official can re • • t ,-: permit for dust cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X i i 6c 63(,//7 9/3/h)/
Signature Contractor's License No Date
Permit Valuation h200 .- 620 Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ / / 9,,-- Water Meter Size 5/8 "; I "; $
State Surcharge $ 2' U D 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 epttiey 9 &13 $ /7/....1
--
This Application Becomes Your Building Permit When Approved Paid /7/ 91 Rec t No. /06,31
Date / /' /'S By
Building. Official Da e
This is to cern thapt,c request in the above application and accompanying ocume is is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signet r th • y Planner cdnstitutes a temporary Certificate of Zon g corn lance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued //
y¢ /
'_ Planning Director Date Special Conditions, if any
---- -- 24 hour notice for 11 inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS / .7/ 3
TYPE OF WORK t
USE OF BUILDING IFf .4 /A
PERMIT NO. /3. q73 DATE ISSUED 9. a • i3
BUILDER p/f � ? l i PHONE # l j° 3 9i-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING 1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
*KW 1 1
I FINAL 1
FOR ALL INSPECTIONS (952) 447 -9850