HomeMy WebLinkAboutBuilding Permit 12. 0696 J
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE(if \
enen /
AND UTILITY CONNECTION PERMIT ' L` 7 ll'`
114NEgOgP 1. White C
Pink Cit
ke ity
2. PERMIT NO./� ( j
3 Yellow Applicant .r .l
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
17 2- Cote 1 DSO /4 rC) / ., V -S E-
LEGAL DESCRIPTION(office use only)
LOT 6 BLOCK 8 ADDITION WOOD i A 4"E T-1)-Ts Z7-0 / IVPID
(Name)OWNEt: tA L . EAT� NS c7/� /'�1i9'�2(Phone)Cci 4 Z 26 —33 95-
(Address)
. -(Address) 17 4 6 l0 To 12-0M TO A1i..E SE . /Od- K-£ M N E,_5----,5 7Z
BUILDER ��L-F
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction Deck ❑Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish 0 Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: 1'I.R.C. ❑I.B.C. 0 Misc.
Type of Construction: I II III IV V tl`, B PROJECT COST/VALUE $ ` a,
•
Occupancy Group: ABE F HI M (V S Uii
Division: 1 2 3 4 5 (excluding land) s- fG/�d0 AI-7- "1
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
officialranr.• e 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.
CWZs/iz
Signature Contractor's License No. Date
Permit Valuation 41 V U O-00 Park Support Fee # $
Permit Fee $ 73 75 SAC # $
Plan Check Fee $ 47 v. 94— Water Meter Size 5/8"; 1"; $
State Surcharge $ / ., 66 Pressure Reducer $
Penalty $ r 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 ditt az 9 / $/2_z......, 2
This •''` iLIIIIIIII
Becomes your Building Permit en Ap oved Paid /Z—Z._.ee 91 R eipt No. 6)6..570
4 , Date ,.. 2-1, /L./ •
uildine Oft= Date
This is to c /4, that ••requ t in the above application and accompanying docu encs' in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sig e j Pla er conshtu)Cs a temporary Certificate of Zoning c plia a and allows construction to commence. Before occupancy,a Certificate of Occur must be
.,
issued. 1
( d
Planum_":- • 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
DEPA
TMENT
F
PRIOR LAKE BUILDINGINSPECTIOND�NSPECTION
INSPECTION
R . CORD
SITE ADDRESS Or . L!L. • k LIQ A _
TYPE OF WORK
USE OF BUILDING .� A
PERMIT NO. t Ar'y l DATE ISSUED
BUILDER J171 PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELC)
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING Inl-- I egECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
imme 1
IFINAL 'LUG g
FOR ALL INSPECTIONS (952) 447-9850