HomeMy WebLinkAboutBuilding Permit 13. 1272 s 0 o� c) ❑l1o ❑ o ❑ MO > 20
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of PRio CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
�, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE J lPV
AND UTILITY CONNECTION PERMIT /
ti
���NESo�� I. White File
2 Pink City PERMIT NO./3,. ` Z7z...
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS� /, /�'¢� ZONING(office u e),
395q O BR/e Coagr 5�jO r!I�1►1 j D
LEGAL DESCRIPTION(office use only) / �� E s� v�
LOTBLOCK2--- ADDITION ��K s����.5 PID ,�%:�• 1il�l� '—�i�i��� ,
OWNER .�-+ ,,l
(Name) / DNj�/ (N�eL (Phone)
(Address) 6, A•/OW:
BUILDER M CO051R OW b&) `y
(Company Name)J V (� n/ /AK-- (Phone) �e ���t)(45—(-1/8‘)
(Contact Name) J Erf 12 Vi-501Ckk (Phone)
(Address)( S cok ry Love— Rco-t) 3j ,' Z. ,1u
TYPE OF WORK 0 New Construction ' eek ❑Porch DRe-Roofing DRe-Siding ❑Lower Level Finish 0 Fireplace
❑Addition ❑Altera ion DUtility Connection
CODE: R.C. ❑I.B.C. 0 Misc.
Type of o struction: I II III IV V A B PROJECT COST/VALUE $ J 0OD
!
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 that the building
official can revoke this permit for just use FurthermCerebYatreethatthecityo
fficialor a designee may enter upon the property to perform needed m: ctions
91 �, zbG3 3770 ,e/ -8 /3
Signature Contractor's License No. Date
Permit Valuation 5/ U 6 U 06 Park Support Fee # $
Permit Fee $ j/7. 75 SAC # $
Plan Check Fee $ -2te . 5 Water Meter Size 5/8"; 1"; $
State Surcharge $ Z ` 0 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/_/3./ $ /?60,
_, i -
This A ' ati. Becomes Ysur Building Permit en A oved Paid /7k.77 Receipt No. JQ -19-
1 Date ////5Y43 By rte•
/� /I._��� /)
t.. 3
B tidme Official Di e
This is to certify that the request in the above application and accompanying dog ument is in accordance with the City Zoning Ordinance and may proceed as requested. Thu document
when sign-u.y th�%ty Planner constitutes a temporary Certificate of Zoning ample ce and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued. __
I-40,,...... 1/
1 'ammng • . -••'..........__ — Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
DEPA
TMENT
F
PRIOR LAKE BUILDRNG A DONSPECTION
INSPECTION
SITE ADDRESS 1. ado r, M CT: —
TYPE OF WORK
USE OF BUILD A RIP
PERMIT N• � I"IS`M�F�+ =TE ISSUED 114
BUILDER 1;11 _��J � � PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING
PLACE NO CONCRETE UNTIL •,'E HAS BEEN SIGNED
Mir
IFFNAL 471' Jv[i
s
FOR ALL INSPECTIONS (952) 447-9850