HomeMy WebLinkAboutBuilding Permit 14. 0157 CPRisO� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
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AND UTILITY CONNECTION PERMIT
I White vESotr 2 Pink city PERMIT NO. 1(.,� _ /5 7
Yellow Applicant ll
(Please type or print and sign at bottom)
ADDRESS ash 3 /4, c e(), -'i c ) eu 5. S ,(.,‘,D ZONING(office use)
�.33c -,—. -7L--i:;°-e- e.—�z — PUS 0
LEGAL DESCRIPTION(office use only) /�
LOT BLOCK ADDITION PID Ci 5'�-(g q - [.(i7` V
OWNER
(Name) ��14 A.) Z 141—'7-,A` CA i—4( LI/3 (Phone) /— 4/80— Z zo S C
(Address) 3 3 ' S1'fr...,-/L Z G'«c 4. 6.3-
BUILDER
(Company Name) �U :6o0Z 60 Lc." /v ' (Phone) 9.5-- - /qo`cv?q /
(Contact Name) -Z/'"'i Fu/plc (Phone) 9J—g —02 9 2-C Z. .,?).--
(Address) '.93// (0 U7i-1cO UU'C- ,Q Lnv i I' L Z41e_z,
TYPE OF WORK 0 New Construction (Deck 0Porch ORe-Roofing ORe-Siding ❑Lower Level Finish 0 Fireplace
t ❑Addition ❑Alteration ❑Utility Connection
CODE: I.R.C. ❑I.B.C.
0 Misc.
(>4.,Type of struction: I II III IV V A B PROJECT COST/VALUE $ /-3,A
Occupancy Group: A B E F H I M R SU (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and con ect I also certify that I am the owner or authorized agent for the
above-mentioned property and that all const tenon 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 pe,it for just caul,/ urthermore,I hereby agree that the city official or a designee may enter upon the pioperty to perform needed inspections
X /—s. Date
:tgnature Contractors License No,
Permit Va nation1( Q(, J Park Support Fee # $
Permit Fee $ /f) 67
SAC # $
Plan Check Fee $ . / Q Water Meter Size 5/8"; 1"; $
State Surcharge $ —) Pressure Reducer $
O
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 $ TOTAL DUE $ ''7/. 95—
4.-.4_,,,_,-7-) 3�z I !4
This App14 tion^Becomes Your BuildingPermit Wh Appro, d Paid I'i f, Lf S Receipt No. '`(7 y.� v
i(
�� � Date 3 a�•, . / �- By d'�,
sir iii ung Official Date
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This is t tfy th i the request in the above application and accompanying doe ents is in cordance with the City Zoning Ordinance and may pioceed as requested This document
whe s , 1' - _
L by th City Planner constitutes a tetporary Certificate of Zoning mpliance a d allows construction to commence Before occupancy,a Certdicate of Occupancy must be
tsst T
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Planning
r ate Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
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SITE ADDRESS '_9 35 (
TYPE OF WORK . Dni . -
- , USE OF BUILDIN =xtt,t .-: . , , ` .<: : , 4
' , PERMIT NO.: (. � DA ISSUED 32.6 j
BUILDER -0 ...046 7i4,2S- II'ic :: PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW ` :
' THE PERMIT IS BY SEPARATE DOCUMENT,
� INSPECTOR DATE
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FOOTING t4'c t�{`P = 1�.., r j. 1 1�
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIG ED
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1 ANAL . ` ' -L- I r114 It 1
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p�� _INSPECTIONS 447 8 -
I SPE S (952) 9 50
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