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HomeMy WebLinkAboutBuilding Permit 14. 0391 ❑ ❑ n 0❑ O = 0 c E c� O � mHm �m z 70o m � 3 n n 53 x' x) o m cEE -4 m x m n� by o z 3 r 3z _+ z to LI r m m A Rt 2 � = OZ to �' r' n n CO Z 0 � 0). 0 o z73 to g s -+ > y N zz °z o� n 0 r c •, z o z m m m _ > 0 m m z rt+ , 0 O Q1 000000 �l ,21 x m m m may > mII *, z XE mmzM m 0 �i n 21 ' 7 1 �� zzzpz — z 3 z .\ m Cm) 6 0 rm000 73 _•1 e. ) Co 0 0 z z 7 7 zr �°• 0 71 m r 'a -o P o A C 0 ..'t" Wm 0 000000 m x a � „ m, o xi.z ` m ymm3n V`J R1 z lii m -1 _ 2 r m -II- 0 tc--A: N.1PC:27 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec d TEMPORARYAND UTILITY CON ECTION PERMIT LIANCE LANES .White Fie . City PERMIT NO. I 3.Yellow Applicant / (Please type or print and sign at bottom) ADDRESS � ZONING(office use) 4C©7 43/)9 li //a, Q �. /? 4h 6-6322 LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER Ale (Name) .L� (Phone) 9 36o (Address) was Y);-2,.A.). 847„ " 30t)� 1 65 X39 BUILDER (Company Name) - ) - (Phone) 9.5;) ey , (Contact Name) .c) �) , (Phone) c 2-,tel z4 (Address) /O 2 ) ��T � zi2(.l [x/�Cs4°, ,� /M /. h??L i ,757o2(J TYPE OF WORK 0 New Construction ['Deck ['Porch We-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace ❑Addition ['Alteration ❑Utility Connection CODE: ❑I.R.C. ❑I.B.C. 0 Misc: Type of Construction: I II III IV V AB Occupancy Group: A B E F H I M R SU PROJECT COST/VALUE $ 30/' Division: 1 2 3 4 5 (excluding land) I hereby certify thay7I 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 a ant for the above-mentione L.operty and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I. ' aware that the building official can rev 1"'this pepuit for just , . *ermore,I hereby agree that the city official a designee may enter upon the property to perform needed 3z17 J ignature Contractor's License No. l ate Permit Valuation Park Support Fee # $ Permit Fee $ SAC # $ Plan Check Fee $ Water Meter Size 5/8"; 1"; $ 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 $ TOTAL DUE $ This Application Becomes Your Building Permit When Approved Paid v 7c Receipt O 7/ Y Date S�.L(��/� By < . Y Building 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. Thi: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