HomeMy WebLinkAboutBuilding Permit 14. 0427 I
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�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
., \ B TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT (--.4-
.4.„,-4,,,ESo•S
I.White File PERMIT NO. // ,1z7 7
2. Pell City /�f. • �/
3. Yellow Applicant F —'
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
161(8 9 HAWK Rt oG c_3 Wv\i Pas D
LEGAL DESCRIPTION(office use only) '1
LOT BLOCK ADDITION PIDd `' 0 2 ' 0 13-0
OWNER -c-
(Name) ‘-- i�,
(Name) 1AV k' ) Y�ZUS (Ph ne) 6 a . \9 Si ` 79
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(Address) 17 ./�'O0
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction )eck ❑Porch ORe-Roofing ORe-Siding ❑Lower Level Finish 0 Fireplace
❑Addition DAlteration ❑Utility Connection
CODE: 71.'.C. DI.B.C. 0 Misc:
Type of C• ,.truction: I II III IV V A B
Occupancy Group: A B E F H I MR SU PROJECT COST/VALUE $
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 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 that the building
official can revoke this permit for just Furthermore,I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections.
—5- bZ—L
Signature Contractor's License No.
IL'B
Permit Valuation 3` 000 00 Park Support Fee # $
Permit Fee $ 0 $ 2-6 SAC # $
Plan Check Fee $ 57, 36, Water Meter Size 5/8"; 1"; $
State Surcharge $ / SD 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 NAturx ,5(-7,14/ 4, $
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This Applicatio -.',, Yo Building Permit When A,. ov-• Paid 1 I. I( Receipt No. ""/
r]i"fes.
4 �� Date .3).I t--f- BY ..- -4-14..)
B "ding O resat ::'-
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This is to certify that the request•, the above application and accompanying documen in ace ce with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City i onstitutes a temp�brary Certificate of Zoning compl• ce and ows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
•
Plan e g Director Date Special Conditions,if any
24 hour no i e for all i spectio s(952)447-9850,fax(952)447-4245
4646 Dakota Street Si.,Prior Lake,MVlinnesota 55372
F
PRIOR LAKEDEPARTMENT ULDIG A D�INSPECTION
INSPECTI N
RECORD
SITE ADDRESS /0 D e W% 4OEtj
TYPE OF WORK
USE OF 47
'TYPE rive-
PERMIT
� �,
PERMIT NO. i�. At DATE ISSUED
BUILDER PHONE # r
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR/1 DATE
FOOTING
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
11111.111111
FINAL
FOR ALL INSPECTIONS (952) 447-9850