HomeMy WebLinkAboutBuilding Permit 13. 1013 J
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o f 1414)1 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
. ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /
fti AND UTILITY CONNECTION PERMIT 9 l 2 •
4NESdtr I White File Pink City PERMIT NO /3 / ` / // .? 3 l / /�
Yellow Applicant ✓
(Please type or P rint and sign at bottom)
ADDRESS ZONING (office use)
3 1 1 4 V, Ct r _ 5 U e ca r (Z. P64
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID . 4-€74 We'. 0
OWNER -T1 (
(Name) Z 0 G A<,\ * l \c ''■∎\._ 1 rS0 N (Phone)
(Address)
4t
BUILDER _
(Company Name) -T� l..- 0A-C Iii. 5 (Phone) ( (24' ' 7
(Contact Name) � a ■'� i t^`` k Q QQ (Phone)
C (Address) ( C( i l � \ S l k& (Co reA. cci 7 1
TYPE OF WORK ❑ New Construction Deck ❑Porch :Me- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
❑Addition ❑Alterat on ❑ Utility Connection
CODE: .R.C. ❑I.B.C. 1:1 Misc.
Type of nstruction: I II III IV V A B PROJECT COST /VALUE $
Occupan Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authorized agent for the
above - mentioned property and that all a ` - on 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 revoke this per us ,+ tse Fu hermore, I hereb ; •e that the city official or a designee may enter upon the property to perform needed inspections.
X ( C- (3 1 10 C Z ( 10(( 3
-":'! a Contractor's License No. Date
Permit Valuation ' i Park Support Fee # $
1
Permit Fee $ :Z. SAC # $
Plan Check Fee $ 4 ') Water Meter Size 5/8 "; 1 "; $
State Surcharge $ r_ � p Pressure Reducer $
Penalty $ ( Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $ 1
Gas Fireplace Permit Fee $ TOTAL DUE 1 /4 • /....3 $ ( ! i � 1 ! 1
This App c io i•/- co �� s Your Building Permit When ppro ed Paid 7 / R eipt NO. �1 Q d �� j, � Date c 2-7,,/.3
.,
4 /A_ _ i r 3
Bui dine Ofilcia Date
`
This is to certify t� 4 +se r st in the above apply�ation and accompanying documents is in accord ce with • City Zoning Ordinance and may proceed as requested. This document
when signed by t� hty er constitutes a temporary Certificate of Zoning compliance and all s constr tion to commence. Before occupancy, a Certificate of Occupancy must be
issued
• arming • tree or Special Conditions, if any
24 hour notice for an hi,pc . 952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECOR
SITE ADDRESS - /d
TYPE OF WORK I �,,
USE OF BUILDI
PERMIT NO. BATE ISSUED "Ally
BUILDER I,��1i -tI�4g PHONE 4p4 , ,.i 7rg
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING 1 A0-4 1 e%'' 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
*NIA 1 1
FINAL 2 /` G 2
r
FOR ALL INSPECTIONS (952) 447 - 9850