HomeMy WebLinkAboutBuilding Permit 13. 1201 0 ❑ 0 0000 ❑ s 0 > Nc)
n 0 S. )3 73 7 3 mDC�c m m m p 0
` o
m y m co ) > z H O�
Z 0 G) G) z 0
1 - m 0 z
b `�•� n N z = O
0 2 o n A ` \ ❑❑❑❑❑
nC x3mx3 m \ -11,12Z73732.3 m O ' I l i - >09p0 0 3 1 r-rt 00 =� z z t
0
x
m ,\ � 00 000 0 \tv
Z 1 n n
0 M°> mm m
O ry -
v
Z mm
y n D - 1
-4 m
r
0 PR /04, `�
�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
4 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /0 zg /3
AND UTILITY CONNECTION PERMIT
t kwES O �
I. White File
2. Pink City PERMIT NO. J3 , /f
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
16985 Lyons Ave SE /SO
LEGAL DESCRIPTION (office use only)
LOT 24 BLOCK 5 ADDITION Prior South PID ?. 6/1 /06-o
aa m j Avis Johnson (Phone) 952 - 457 -8647
(Address) 16985 Lyons Ave SE
BUILDER Superior Exteriors MN Inc. 612 -382 -2549
(Company Name) (Phone)
(Contact Name) Steven Elie (Phone) 612-382-2549
(Address) 4520 Tower St. Edina, MN 55424
TYPE OF WORK ❑ New Construction ['Deck ['Porch [ate- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
['Addition ['Alteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ 12 , 200
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished 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 laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke pe 't for just cause. Fu ermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x ..A.....". J B C 6 3 912 9 10/22/13
ignature Contractor's License No Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ / 'Z1 Water Meter Size 5/8 "; 1 "; $
State Surcharge $ 5.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 $ r
Gas Fireplace Permit Fee $ TOTAL DUE $ J
� �
This Application Becomes Your :. .1 ding Permit When pprov d r Receipt No. 05
Ai,- 0 2r ate /0 7 f 1 / � By A
B.' ding Offal,/ Date Please mail permit to home owner
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 S.E., Prior Lake, Minnesota 55372