HomeMy WebLinkAboutBuilding Permit 14. 0874 I O»� ( n 6OQOO o » ■ 0
n Os� � � § § sg4
n o \ o o . 3 � c�c � m § m 0m
§ r R 2 2 Xt4 4z � � §§ � 0 �1
hi r 0 0 2 $ Q § ® • z-
/ k ° ■ > = k^ cn § z z §xi
§ k z 0k
n o •
� m m
K X r z
r o
,
m 2 0 § I. . 000000
X m§ § m mri > mr
0 § o o I Occ
..
m lw TI § ■ § $ § m 0 co
% 2 m ƒ m | > 000 § 3 z : . m
§ / z rm §§ 2 ei
r
§ z \m i R 0
■ o I
z m —0o n
2 = QCOOQ
§ � � n g
0 K 'a-o -a �41 �
\ 3) m K
zo . » 00 -,
k 5i if Ea
-4 § 0
PR/04, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
F° ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �`7 Z, I
AND UTILITY CONNECTION PERMIT
Cr.)
In
�r�NNE$D•tP I. White File PERMIT NO.
2. Pink City
3 Yellow Applicant griEti
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
i 561 Shoc,-e. LC,& Y —e P05.2)
LEGAL DESCRIPTION(office use only) l /
LOT t BLOCK ADDITION Libgc;i4f..d /7—` fr(falof PID 15 -. j5+ 9g i
OWNER(Name) .001,r\i'-- YYU- Jlik -.E., (Phone) La • D 1 S3
....-
(Address) 1
BUILDER
(Company Name)- ,P S2 , (Phone) (OS -a .01 � f
(Contact Name) (Phone) .
•(Address) 0 . diA..' \�>�
f\ 5 11
TYPE OF WORK ❑New Construction ❑Deck ❑Porch ❑Re- fing LaRe-Siding DLower Le el Finish �❑F/ireplace
DAddition ❑Alteration ❑Utility Connection V�� �N CJA,J`a LAM I✓I
CODE: ❑I.R.C. ❑I.B.C. ❑Misc I S 'r 9 Q�s(�Ylr
Type of Construction: I II III IV V A B PROJECT COST/VALUE $ 5� 6 aD
Occupancy Group: A B E F H I M R SU (excluding land)
Division: 1 2 3 4 5
I hereby c tify that I have f irnis.,, nformation 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- e toned property and sat al 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 c ..revoke this permit fo a cause. Furthermore,I herebyagree tha cityoffi ' a desi nee ma enterqtoPerfOrrnnec)the rty ddins c msX • ' l
/ ignature Contractor's License No. Date
Permit Valuation / Park Support Fee # $
Permit Fee $ iik i�C)c SAC # $
, i 4
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ 5 (. " 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 $ 11 ° ,S2'
This Application Becomes Your Building Permit When Approved �e„/ 1t(4` i 1 Receipt No. ,
Date1111
By
k 4-
Building Official Date q,--73.-.
,....)t
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. Tsis 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