HomeMy WebLinkAboutBuilding Permit 15. 0322 a q - I-
P E. ui §
4. � Zww < 0 %
bmii
■
❑ 0000 UJ
> 2
Sce
UJ
X
CV
U. /
w d § § � m k § q
0 ' � ri e § § � -1 ; o 0 b §
0 0 W co ■ xreco1 rz \ co
|
■ U § 0 § j0 2U) I
a ■ ■ ■ a ■ ILI u) ul § U
o 0cc 00000 i C) 0 cc
220
& § § t
O o U
5 r NA § k c a §
& § § c
0 z 0 w Cn <
IL§ ■ g 2k2\ Z W � � LU -I %
�� kk �� � § ix k
& 0 0 U. U. U. ■ ■ § o k0 a §
5z < 0 a 000000 0 0O I
0 F pRto CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
® "' �P TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
�' ' AND UTILITY CONNECTION PERMIT
t.,
��NESO11* I. White File PERMIT NO.
2. Pink City 15
— 3 ZZ
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
3040 rotC 'c tw RD a d 6t
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
ONWNER it ,.t J" 1.1 lS A 0 1.. (Phone) VI 7 1 a 3 n - T Lir Q L
(Address) 3 O LI V ra , r v 1 t Lel n V Gi (1 so
BUILDER THD At-Home Service, Inc, 9 62/3�l S • I. V 7
(Company Name)_ 2690 Cumberland Pkwy, Ste 300 (Phone)
(Contact Name) _ Atlanta, GA 30339-3913 (Phone) J o di
(Address) Lic#CR268257 Ph. 763/542-8826
TYPE OF WORK ❑New Construction ❑Deck ['Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finis ❑Fireplace
❑Addition ❑Alteration ❑Utility Connection 2 . n r d a a P 4 p tQ cj /7 S s rn
CODE: ❑I.R.C. ❑I.B.C. gMisc. JY f f / Q op �t n in ft
Type of Construction: I II III IV V A B /` 0 7
Occupancy Group: ABE F HI MR SU
PROJECT COST/VALUE $ 'S
(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 than the building
official can revoke this permit or just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform neededi spection
\pi ---- --- CRa �. B '2ciSit to iii
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $ •
Permit Fee $ SAC, # $
Plan Check Fee $ 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� $
This Application Becomes Your Building Permit When Approved Paid ' 14,1 c R ipt No. (b 0--
Date
—Date ,- 4,4-,VC B -
Building Official Date .
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
•
Planning Director 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