HomeMy WebLinkAboutBuilding Permit 12. 0027 r ° (0(3'k CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd AIN1 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTIO PERMIT
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ISC File PERMIT NO
(Please type or print and sign at bottom) ' 3 • ow A Gcan` /� Z�
ADDRESS ty '3 y 3 p± t2 i1-S I 0 E C-- -- 1 7 ZONING (office use)
to . 3 i._ LEGAL DESCRIPTION (office use only) yc 5C l
1 LOT 55 BLOCK ( ADDITION J �= t R5 w .A ice. 1 13 N - i - ` PID 2-S 4 - IS o SS O
OWNER
(Name) ' A T i N I-1' T' -14 U NI ES (Phone)
(Address) 12(1.1 W A S t-1-1 ht 6 — ► u +.1 A/ E S STa 'z i t -O t 1-..1 4\ H rJ S S 4 3 9
BUILDER
(Company Name) M'Ar 1 "l +) 1 ES (Phone)
(Contact Name) S v E 8A.s.12 ' (Phone)
(Address) 12.0 ( ts., k S 1-} ti-, - rUj A vE. $ 5Th- 2_O t t -01 >v ti H t�1 SSA 39
TYPE OF WORK Jg New Construction Deck ❑Porch ❑Re- Roofing ❑Re- Siding (sower Level Finish ❑ Fireplace
DAddition ❑Alteration ❑Utility Connection -
CODE: ❑I.R.C. ❑LB.C. ❑ Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ 1 5, 0 0 0
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 this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Xc ‘-^■ 1 --- e—_ BC- 203"1 53S
Signature Contractor's License No. Date
Permit Valuation Z. , 00 D ,_ 0 O Park Support Fee # $
Permit Fee $ SAC
Z— 2-3 # $
Plan Check Fee $ Water Meter Size 5/8 "; 1"; $
State Surcharge $ U Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ 54 53 Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE 6/ (‘ /Z $ /./ 7 7
This Application : ec Your Building Permit When Approved Paid /17, 75 Rece t No. (y #9& Z
/, to • /Z- Date /. /0 / 2 - B ,
Bu' g Official 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 S.E., Prior Lake, Minnesota 55372
P R I O R LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPE
RECORD
SITE ADDRESS /4343 PA re-KS I DE C,� ..
NATURE OF WORK LO WEo2. te?/FZ,.
USE OF BUILDING ` 6r4/
PERMIT NO. 17. . Z DATE ISSUED /- • / Z-
CONTRACTOR M t tiy Hones PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
*NM 1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION _.
ELECTRICAL
PLUMBING
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 1
FINALS
4. BUILDING
t ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough -in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447 -9850