HomeMy WebLinkAboutBuilding Permit 13. 0451 QJQ
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ePRI-ON CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
A TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /9 /3
v V AND UTILITY CONNECTION PERMIT CO
44,1,,E vitt" 2I. Pine File
PERMIT NO13 S'� �5/ ,
3 Yellow Applicant
(Please type imprint and sign at bottom)
4.1
ADDRESS ZONING(office use)
f 6 093 �Q, w j2 ('ate' E
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(Name)\c.
ER fi✓�n C(f cl`'a2 (Phone) 657-02 3i .-Q I
(Address)
Y BUILDER / - I c
(Company Name) v r 164.tes J-f �� 1 (Phone)
{Contact Name) TG.)o.-'' J%'fit r/1A (Phone) '(OZ gl° 6v 6647
(Address) 7?CG !M _ .moi C.. 5,4-0 'Z2- vf"i'v' r5s 3?U
TYPE OF WORK 0 New Construction eck ['Porch ORe-Roofing ORe-Siding ❑Lower Level Finish 0 Fireplace
❑Addition q rDAlter o ❑Utility Connection
•
ODE:'DI.R.C. •Di B.C. 0 Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
'# Occupancy Group:" A B E F H I M R S U (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 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 tut the building
official can revoke rmit for just cause.`1✓urthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed nspect fns.
Signature Contractor's License No. Date
Permit Valuation 'to op, --- Park Support Fee # $
Permit Fee $ -,; ..-I C SAC # $
Plan Check Fee $ 47.14 Water Meter Size 5/8"; 1"; $
State Surcharge $ 1• — 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 $ 1 2 2 ,(f
This A, pli ion Becomes Your Building Permi When pproved Paid
�--yr„-2.-7 _.)1
2 �� Receipt No. �'pr(3, Z
Date ��Ic> By
wilding 011icial Da
This is to certify that the request in the above application and accompanying ocume is is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when si ed byte City Planner constitutes a temporary Certificate of Zoni g compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued. /
.__ ---__, I 1, fr3 1-. (.5 ,....,-, 1-S,-t.,_–to —gd-rir_v, ja..4,0
Planning Ditectg3, Date Special Conditions,if an
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
ARTMENT
PRIOR LAKE BUILDING A D�INSPECTIONV
INSPECTION
RECORD
SITE ADDRESS /(,Oc3 #40477114600 I42 .
TYPE OF WORK DEW.
USE OF BUILDING �Q�f' Alit
a 4.57 DATE NO. ISSUED 6, /9, /.3
BUILDER RaSMHOS'� PHONE # &a. ,p'/O.4,GGL
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR �u DATE
I FOOTING I P Le- 1P - 11
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
1.10141,
JFINAL 016 0/6- 3
FOR ALL INSPECTIONS (952) 447-9850