HomeMy WebLinkAboutBuilding Permit 13. 1231 J
g J E it cc ` W E
4,,, gaa t > "
,o Nok 000000 > a re
.\--•••■.44. \ 1\ W O
N C ILI L: Z col
W O »4 1 1 ` V m c O ka
G \ c i F- re oouu..J ' i O Q. 0 a '
_ g W a
0 O W Z� z � W N CZ I
co U d m Zt � il � m Y � a 0 z
W Q yj - W W W W W Li • III D00DDD \ h a 0 z
W
�� d d
U. H
w0 Z \ U re z z 0 c
O Q 0 \... z .
Lc. rl IQ
o z 0 o 0 N N Q \ u9
Z F= a ►- E
F- <
0. ° N o Z0 Z JJ z W L W su
u. Li W W O7X �Q�t! a OC re _ . 0
O W a W z OO12 z 2 0 0 0 V
h
N a o u . u. u. p 3 0 0 a
U Z a 0 a 000000 0,0 ❑ c
° F PRT; CITY OF PRIOR LAKE BUILDING PERRT Date Rec'
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /
AND UTILITY CONNECTION PERMIT ` f /3
~i� treso t � 7 . W hite Fife PERMIT NO. / iz 3/
I. h,i City
3 Yellow Applicant t
Please orprint and sign at bottom)
ADDRESS Z ONING (office use)
f:�5 hiuW► rn /tn5b �1 rck 1( NE A'
LEGAL DESCRIPTION (office use only) ` / / /�
LOT/ ?BLOCK /VOA VOA / r ! ` 4 Z O P I D a7 , 5- . 3 O ei
OWNER ' 1 t Yvi C >l t, i1-e- I Y 2 // 3370
(Name) ` (Phone) ( 5 , 1
(Address) - 4520 1-f uk rr) 17) , n �°I) C..! i i rc< I / `I 11 pr�/ L-.
crf ct J��
BUILDER `J
(Company Name) / 1 0 e (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction []Deck ❑Porch Re- Roofing 0Re- Siding ❑Lower Level Finish 0 Fireplace
❑Addition 0Alteration ['Utility Con cu n
CODE: DLR.C. DI.B.C. 0 Misc.
Type of Construction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F Ii I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certity that 1 have tutnished information on this application which is to the best of my knowledge true 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 Iaws and will proceed in accordance with submitted plans. I am aware that the building
official can re ke this permit fo just cause- Fur , ore, I hereby agree that the city official or a designee may enter upon the property to perform neede inspections.
x ... #' _ 1/ 1 //
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ 5 . Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $ ■
Plumbing Permit Fee $ ' 1 c Water Tower Fee # $
Mechanical Permit Fee $ 11 Builder's Deposit $
Sewer & Water Permit Fee $ s Other $ A�
Gas Fireplace Permit Fee $ TOTAL DUE $ �7V. '
This Application Becomes Your Building Permit When Approved Y i 1 .5.
Receipt No. -70 3 ICJ
Dat By 5A-- .
Building OfIii 0 Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372