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HomeMy WebLinkAboutBuilding Permit 14. 0800 Au s CD I/ , S ■ ■ ■ ktu) § « Lij g3 U ■ k a. ‘,q,„N'. _)l § ir � 2 > z OCOOOc u> 2• § m m o y _ Ci aa � ¥ o X J / 2 2 K & £ o o� � � © c o § z B 2_ iz7/ Mill § Q U ® : 0 a �7wx� � U a § , ` . wa§� � q 2 J 2 $ a ■ ■ coal III 2 « Ci oOooOO § 2z 2§ $§ § ix 0 \ k § le $ K la % �a. U ° ��-Ik UJ k v v t e4 it © �J�W re W 22 \ re q az k $ OOO/ O\ ■ 0 § , . )c0 s OF PR/ pt. CITY OF PRIOR LAKE BUILDING PERMIT, �� Date Rec'd o TEMPORARY CERTIFICATE OF ZONING COMPLIANCE x mAND UTILITY CONNECTION PERMIT F , , r �''4VNESO White File 2. Pink City PERMIT NO. 14 ...C./42 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 3 ' t, S? 4/10, 1colivi 6tf4- 156 LEGAL DESCRIPTION(office use only) LOT / BLOCK ADDITION P{-/0,e, (DerdS(L)IdPID., — /123•- /_ OWNER (Name) �1V4 (Phone) 6 f Z_ -70 O/ `5'3 4/3 (Address) 3 2)b Q AA (C il.- (..o,-1 BUILDER mpany v(I !4 tS 1-l. C // 1 Z ' � ) if'Z- �,�5 (Company Name) ,/� f '� �' I �� r � � �' (Phone) K (Contact Name)/ f 3 V 1 S Itt' ,t J (Phone) (p1� S ci- 2.e I b (Address) 31,21 `Lg /'4 4 lir , mi4 riS,A 1 IJ', c 'cc.L TYPE OF WORK ❑New Construction ['Deck ['Porch ORe-Roofing ❑Re-Siding ['Lower Level Finish 0 Fireplace ['Addition ❑Alteration ['Utility Connection J `,�T` � CC-bAie 'g X,f5�(/A) CODE: .R. C. ❑I.B.C. ®Mise. Sqfie,r7L 5//2/17/ Type of Construction: I II III IV V A B PROJECT COST/VALUE $ / v 0 Occupancy Group: ABE F HI MR 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 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 is perm for just c se. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X gZ 6 S 06L 10010 Signature Contractor's License No. Date Permit Valuation 5-ea. - Park Support Fee # $ Permit Fee $ 2-c,- SAC # $ Plan Check Fee $ ( Water Meter Size 5/8"; 1"; $ State Surcharge $ e'S, 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 $ TOTAL DUE $ 4(..1C- This" •rThis".l• ion BecomeTYour Building Permit Whe App ved Paid 41.(7 Receipt No. I r ( Z-- l+ ,� ei Date 0 f- By Bi „Official D to This is to cerci' tha the request in the above application and accompanying docu ms is accordance with the City Zoning Ordinance and may proceed as requested. This document when signed the y Planner.constrtutcs a temporary Certificate of Zoning co tlianc and allows construction to commence. Before occupancy,a Certificate of Occupancy must be issued /6 . ,m,. V """Ili lanning Director I.to Special Conditions,if any 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street Prior Lake,MN 55372