HomeMy WebLinkAboutBuilding Permit 15. 0304 CPRtp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4. 9 �-
AND UTILITY CONNECTION PERMIT •
NESD�P I White File PERMIT NO. /<-_-?0,4_.2. Pink City
3 Yellow Applicant r
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
// /1-4,4sG
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER •
(Name) ' L,ii%./=% (Phone) �/d 2i '4'?5 '
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑New Construction Deck ❑Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
❑Addition ['Altera .on ['Utility Connection
CODE: .it ❑LB.C. ❑Misc.
Type of onstruction: I II III IV V A PROJECT COST/VALUE $
Occupancy Group: ABE F HI MRS`U (excluding land)
Division: 1 2 3 4 5
1
I hereby certify that I have furnished information on this application which is to the best of my kno'edge true and correct. I also certify that I am the owner or authorized agent for the
above-mentioned property and that all construction will conform to all existing state and local laws an, will proceed in accordance with submitted plans. I am aware that the building
official can revoke this permit for just cause Furthermore,I hereby agree that the city official or a designee.ay enter upon the property to perform needed inspections.
x /, .. J-9'— r
I Signature Contractor's L. ense No. Date
Permit Valuation 4; 000 f DO 71 Park Support Fee # $
Permit Fee r
$ $�03_ o° SAC #
Plan Check Fee $ /� 5s $Water Meter Size 5/8"; 1"; .
State Surcharge $ 7 0 O, Pressure Reducer $
Penalty $ V Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other �1 $
Gas Fireplace Permit Fee $ TOTAL DUE ei 4.,.60_i� $ /11 95
This`h�lie 41�t'r� ... r Building Permit en App .ved Paid 4-10�/ . Receipt NO.
99-gDate --Ij B f
ri
_ rao
Bu
ildin�� i Pate
This is to certify h t •request in the above appli�t inn and accompanying documents is in acco .ance w' the City Zoning Ordinance and may proceed as requested. rhis document
when signed by i fanner constitutes a temporary Certificate of Zoning compliance and a iws co ruction to commence. Before occupancy,a Certificate of Occupancy must be
issued. , _
_ l("c9 (-) .
fanning Director Date Special Conditions,if any
24 hour ice for all inspections ' 52)4'7-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
DE
ARTMENT
F
PRIOR LAKE BUILDING A D�INSPECTION
INSPECTION
RECORD
SITE ADDRESS i/f/'Rr (,R'Ne Ult.
TYPE OF WORK Dego
USE OF BUILDING /gay*.
PERMIT NO. a_IS• 3�' DATE ISSUED #. gar- BUILDER p�1�/�'O wkife PHONE # */L .74
2451 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
Ai_ INSPECTOR DATE
FOOTING Sae Dro�.�.,,,.,Q {?� S'r • c • CE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SI NED
IFINAL I 62P ���
FOR ALL INSPECTIONS (952) 447-9850