HomeMy WebLinkAboutBuilding Permit 14. 0428 CD a N
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of PRl�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
41 NE sOlP. I. White File2pERMIT NO. L �J
3 Yellow Applicant Pink City PERMIT
7
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(Please type or print and sign at bottom) ,
ADDRESS ZONING(office use)
l6 36c( Tec., I\ c vi, k., G1- iv Le W-15 D
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID V.S. L4S1057-0
OWNER .r
(Name) pa e (t S e) to e r / (Phone) 6 f a_ 3-.t1 <36,->
(Address)
BUILDER
(Company Name) 11C-51/1"‘ Ui e r (Phone) 6 (- 2 e t co c)--
(Contact Name) (Phone)
(Address)
•
TYPE OF WORK ❑New Construction Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish
CI Fireplace
DAddition GAlteration
❑Utility Connection
CODE: I.R.C. ❑I.B.C. El Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: ABE F HI MR SU
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 authorised 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 chat the building
official ca re ke this permit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X / ,, :s77- c/, .'
Signature Contractor's License No. Date
Permit Valuation 3 000, 00 Park Support Fee # $
Permit Fee $ e Q�' SAC #k $
Plan Check Fee $ /"7.3C_ Water Meter Size 5/8"; 1"; $
State Surcharge $ f • 564 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 $ ` l /
/
This Applicat'•i B omes Your Building Permit en . 'proved Paid /,l..7/ �r"etpt No. it
A l Date S , .d r ,y - -
B ildinit •'-c, Dat ,
J
This is to certify that the requc, in the above application and accompanying docume s is in ac rdance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the Ci la r constitutrts a temporary Certificate of Zoning comp ante an Bows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
s S 1f
Plann' g Director Date
Special Conditions,if any
4 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
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PRIOR LAKE BUILDING D�INSPECTION
INSPECTIQN
RECORD
SITE ADDRESS /&3 2flH4i' .4 CST
TYPE OF WORK
USE OF BUILDING a 4/4.
PERMIT NO. Pr" DATE ISSUED �. 2.8 • J¢BUILDER it*
✓ ' PHONE It`/j . Seg. 034
NOTE: THIS IS NOT A PE ' MIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
IFoonNc �
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FINAL k07//..,L
FOR ALL INSPECTIONS (952) 447-9850