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HomeMy WebLinkAboutBuilding Permit 14. 0584 5 0 0 n 000000 U 0 a ■2 2 o § i 0 ■ � 5 -n � n § § 0 5C4 ttl r M m xi k m ; �;C 1 i ! -1 -0 % t � q 2 $ §QqQ P z- q n 0) 0 Z@ §§ z L4y. %WI / 0 0 ' m m i r 0 c4 if -n - • % xi § § 000000q m mmm O z00 � �� � �? m z q § §� _� § m © 0 - E m -, -1 U K 0 o § z m 0 "a 0 V r ,i § o 73 q r• 0 k § � � � p § (Th F X . [-NI r z m ' r.,. c 1• 2 m ......, ..±. _ k OCOClQ ..._3 R. v 0 >xik0§ 0 K < 4..„). mm _i _E � � � � % Z F ;; ; o m 0 ■ m § � . r .... -1 § 0 01 PR/04, CITY OF PRIOR LAKE BUILDING PERMIT, ( Date Rec'd AN ,%, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE !�— AND UTILITY CONNECTION PERMIT Irl kNESD 1.White Fite PERMIT NO. /4 2. Pink City < 3.Yellow Applicant (Please type or print and sign at bottom) ADDR ESS ZONING(office use) / (pCc,`-1 7 blind Lock¢., �rai t SQL LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID (Name)OWNER C✓1 V L\< C a rp VV 1 /15m1 (Phone) 952 D - 5 74) c) (Address) Cp i 7 a I i1 d Lake. 1-ra t I j , BUILDER ` j (Company Name) v aw-4LS 13Otr DS;7r)rl B�l o (Phone) 5 5 2 - �-1 3( -167 0 (Contact Name) <--ha wU_S /�a c Se-) / (Phone) � 2 2.9 2 27 t z-; (Address) 6920 ).i-4(6Sf,. (.J. 5tirk- 100 4.pPI.e.1/ailei� Ml" 55)21 TYPE OF WORK ElNew Construction 2rDeck ❑Porch ORe-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace ❑Addition ❑Alteration ❑Utility Connectionon/G/,� //2v" or d'' "1 y CODE: ❑I.R.C. ❑I.B.C. 0 Misc: Type of Construction: I II III IV V AB Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ J./1'1242- 0 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 age,at 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 official c. '-.•- . ' .. •• . ' - ermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X 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 ` - (s eceipt No. Ill t —, Date �r , Z 1,/ 63y • Building Official Date This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinanceand may proceed as requested. This c.ocument 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