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HomeMy WebLinkAboutBuilding Permit 13. 1276 o b § 2�77x � z 5 �gx CI 2���z e'. § i j 1 2 2 1- z k « k Qit T » ooOOOO 0 7 2 o o la q 0 2 d aa� cc 2 q a w re- z o 2 u- Z 1 #% qt _ , S D o o a , W t Z o o co 0 w N / L Mc o � // f ©�\�§ U / CL § a a f A 000000 2 2 / J ' O o § k CC . z q • iLl / z / k \ k k IQ 2 z / 0 ix < 0 0 z o z U � u. I # p 0 2 2 2 a u- 2 2 $ § w K2Ij� Z ak s k ■ W z o� OgW c0 0 0 $ / 2 /$ 0 0 0 7 2 ■2 A 2 ix ce k / 0 OOOO ■ 0 0 0 2 U U O 0 / o f PRI°. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE { ( 3 AND UTILITY CONNECTION PERMIT I White Fit PERMIT N a - Yellow Applicant (Please type or print and sign at bottom) ZONING (office use) ADDRESS sue I 6 TT I l ao LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER CLA Z f- c.7W 01 et gg-T (Phone) (L2 l L) 1 3 - �L (Name) �/� a FPM p (Address) . G 5 MftvEs Trllpl 1(� S� e PRl o& �5 {� / tl BUILDER E CTE121025 /At. (Phone) (,SJ . 7 &9 Oer) © 4 (Company Name) P,00S -�► (Contact Name) IVW (Phone) es )2_ - 9 qo. / s (Address) 9j6 /A1wo Pry 011-K DtLE 1 PI N 5 TYPE OF WORK ❑ New Construction ❑Deck ['Porch XRe- Roofing [Me-Siding ❑Lower Level Finish ❑ Fireplace DAddition ❑Alteration DUtility Connection CODE: ❑I.R.C. ❑I.B.C. ❑ Misc Type of Construction: I II III IV V A B PROJECT COST /VALUE $ $non Occupancy Group: A B E F H I M R S U (excluding land) Division: 1 2 3 4 5 I hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and correct I also certify that 1 am the owner 01 authorized agent for the above - mentioned property and that all constuctron will conform to all existing state and local laws and will proceed in accordance with submitted plans I am aware that the budding official can r this pet foi lust cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to pet form needed inspections X 6 671 03 /1. / S. /s / Signature Contractor's License No Date Permit Valuation Park Support Fee # $ Permit Fee $ SAC # $ Plan Check Fee $ Water Meter Size 5/8 ", I ", $ State Surcharge $ 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 I $ TOTAL DUE $ 7/ - 7 3 This Application Becomes Your Building Permit When Approved Paid j q, 71, Receipt No.' 7i i/1 / I Date /1 / , ' 3 By e Budding 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 ptocecd 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 Ceitdicate 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