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HomeMy WebLinkAboutBuilding Permit 14. 1057 5 O 6/ n 000O0O - o > 20 n n a Hi . C gJc� oo g rn X° . s m� GE § � m z I 2m ® \ 0 0 ■ m B � ' 0z z �� t � q 2 §Q� Q P Z — ? & § © @ . § § 73 CD � X > 0 XI � % ca X ©Zq ° z nm t / z § #q r o . . ‘. rn k \ k k ctc 000000 1 o Z mrl > mr �c . \ § K frn XC X ! m 0 0 @ E q § 2 § _1 mr § qUz x zq zxz cr _ CO f � � � §§ X7 M • 2 § 4.-- t < OOOoQ _ Qz . § . "I � n > a 0) A � o§ Ja .�` & % a o �9 _ - © U) \ % el �1 § m 73 �q "4 � 2 -1 m -I § B CPRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 9,..2 e L��.f , .t.-.; AND UTILITY CONNECTION PERMIT tri I. white File PERMIT NO. NES��P 2 Pink City //t7/ /� 3 Yellow Applicant t . (Please type or print and sign at bottom) ZONING office use) ADDRESS 16'1`a 3 Lys /�v-e- . Rc - \,- �, P,A) 5`,- q 7't /s,D LEGAL DESCRIPTTION(office use only) _ LOT BLOCK' ADDITION Pr; S9 c PI /7.--—.O� 0, -../71- OWNER A� v�J .J'oL�s 6<-1 .. 3 161 4S�I/ (Name) (Phone) (Address) 16 91. 1- -, A�t�_ - 1 r a ae L iv J 5 t� DER Avt c6,-4^-1 h itSc (Phone) 651 "3/°1--66-11V (Company Name) (Contact Name) Aet d"""' `°`V'"" f� (Phone) (Address) !.6 !6 3 Ly„,,, Ave. c.v. T 1r o - Lokiee,MN S'�,a, TYPE OF WORK ❑New Construction ❑Deck ❑Porch [We-Roofing ORe-Siding ❑Lower Level Finish 0 Fireplace 0 Addition ❑Alteration ❑Utility Connection 0 Misc. CODE: ❑I.R.C. ❑I.B.C. Q 0© - 0 6Type of Construction: I II III IV V A B PROJECT COST/VALUE $ 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 authorizes,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 thzt the building official can revoke this permit for just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspectionIr X • Signature Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee / / SAC # $ Plan Check Fee $� //hf r f �'. _, Water Meter Size 5/8"; 1"; $ State Surcharge r $ / ) Pressure Reducer $ Penalty $ 5 4 (� 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 $ l /-'4' This Application Becomes Your Building Permit When Approved PaQeQ I` l) Receipt No. i_I Date L ,1011�} I B 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. This 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 Prior Lake,MN 55372