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HomeMy WebLinkAboutBuilding Permit 15. 0148 4)6) :-.1. IL 3 / w § � 5 U t ww < z m �0 02 �� fa - 0 0 ra 4 0 < r ) § m � CO z k 4 ❑ DOoc > ■ ` U re x 0 \ w z D 2 §} Z z \ 0 14.1 CI U c2 E O O -J ■ k % z_ U u• U / & 0 a. m = t0Wax . e ■ � � LIC § � � § W ru- W u. N 000000 � � re U % a a 2 I- 0 \1, N 11.1 / 4C a k ( z Ug © 2 © © p $ § 0 Z P u. u 0 a 01 § w w - • - 0F.§ a 2 < 1- b rg 0� co 0 \ DitDZ �- c. 17§ § u.� iL■ ■ § p § z 2 0 a oOQOCO U N3) O 0 E. ti�� \--:\ CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd i ,7-5,4 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE :>I g AND UTILITY CONNECTION PERMIT ,, l( • fro 2 jkivBSDS ;.Wbite iiit PERMIT NO. -. Pink Ci /i5—. 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) /‘/ - LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER _ (Name) 07 (Phone) (Address) /67 e BUILDER /- - �-/. (Company Name) /99 /t/t Q �j" (Phone) ff2 c�7 S —S 'c3 (Contact Name) i c%/r� C I ,e,c i 6 O^. • (Phone) � ..5� S'?CJ C� � (Address) 3 w ZU17 U('/( /, ?//O TYPE OF WORK 0 New Construction ❑Deck ['Porch ORe-Roofing ['Re-Siding ['Lower Level Finish 0 Fireplace ['Addition ['Alteration ['Utility Connection CODE: DI.R.C. DLB.C. 0 Misc: "AC-Q F,./7 /4/9, Type of Construction: I II III IV V A B Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ 7CO Q Division: 1 2 3 4 5 (excluding land) 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 wig conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revokeit for just cause,-n ermor I. -by agree that tha city official ora designee may enter upon the property to perform needed' 'ons. Signature Contractor's License No. Date 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 L q* 1 " Re ipt No. (OA Date Z G By - 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 when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,m�proceeda as requested. This ymustb document issued a Certificate of Occupancy must be 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