HomeMy WebLinkAboutBuilding Permit 14. 0448 J
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of PRt04. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / l�
AND UTILITY CONNECTION PERMIT �D' '
U
sO'ft' I. White File PERMIT NO. ��rJ 4,40
2. pink City /[fj
i Yellow Applicant T
(Please type or print and sign at bottom)
ADDRESSZONING(office use)
x /a8 /100/4i`4/ //A/ �?/Z_
LEGAL DESCRIPTION(office use only)aql
�►y
LOT BLOCK/ ADDITION 711e C 0-�' /�►�OG�/ai® 4�:1Z D Z-c___
OWNER •
122 'o
9W-63 !p
2
(Name) 717/4:,- - 7y (Phone) / /7
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ['New Construction fleck ['Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish [I Fireplace
['Addition ['Altera ['Utility Connection
CODE: 4I.R.C. ❑I.B.C. ❑Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: ABE F HI MR SU
(excluding land)
Division: 1 2 3 4 5
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 igent for the
above-mentioned property and that all construction will conform toall existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can r oke this pe it foruse. Furthermore,I hereby agree the city official [�•a//or a designee may enter upon the property to perform needed inspections.Z /5/
Si: atur- Contractor's License No.
Date
Permit Valuation 00 o. -a Park Support Fee # $
Permit Fee $ s SAC # $
.7 •1>
Plan Check Fee $ 10 cif- 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
/� $ L
This Applic f B t a me• ourBuilding Permit -n Ap,roved Paid j7 �► Receipt No. ( 4'
Date Z By
/`otAr-
AA��.�/�>� 2 I - • ��
Buildine Ofticia Date-
This is to certify that he regkest in the above application and accompanying document is in ac .rdance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the PI n er con routes a tl4nporary Certificate of Zoning compli cc and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
�'` z
'lanning DirechT".111111111111111.11 Date. Special Conditions,if any
24 hour notice or all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
EDEPARTMENT OF
BUILDINGAND INSPECTION
INSPECTION
RECOfiD
SITE AS f(,q2-i' o �'Z DDDRES
TYPE OF WORK 0(eK__
USE OF BUILDING /r/ _
PERMIT NO. )C' . DATE ISSUED ' -
BUILDER ti On-A- # 6i2. i% . 6372.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING I lib G/� 3
PLACE NO CONCRETE UNTIL ABOVE HAS BEE IGNED
Imo , I J
FINAL (0 CA 90///q
FOR ALL INSPECTION (952) 447-9850