HomeMy WebLinkAboutBuilding Permoit 15. 0177 a 0 O 0 000000 -a 0 > -2n
n n \ 0 0 0 . 0 AzK � � � & �q
k x. 0r ri m § § ■ � � �k § -�
/ t !. ... _>, -4 20 P �kq ■ q 0z0 ■\ 0f > 0 mrn§ r § 311 17 x xi £z2 00 000000 _L
o \ 2 0 0 ac � t� -13
c
\ K ? � • k§ § ,3 % § m O \ C) Qs.,_._.
@ E m § •
> 000 0 3 § , m
n 4 0 riOo o
co
k z 71 m r. -a p m
a
k o
I m
( 0Vi C
m \ OCOOc a
z § Q � 11n ' -
a. v o / , a) mm2 § � �
r: 13 J\
4 / � kk §� J
§ . L 7311 ; yr-
2
� tz m
-4r 0
01 PR/04"
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
f.f, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Z . 1 45—.AND UTILITY CONNECTION PERMIT
4`vNBSC;C
1.White Pile
2. Pink City PERMIT NO. /5 /7
7
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
t4LJL PIC3O ) 1ZTsC
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) Vi)N 0 &COI ' ' (Phone) iS 'QQ -- /(d I
L
(Address) v'1`7 YO aLk-131 J� J (I .E ce fike. 6/ 1"1 iu 5S37t
BUILDER A '/yA Q/] WC..
1/1
(Company Name) 1 of U-- ►a"4 V i '/V 1. (Phone) 16 - 010/ ` - p
(Contact Name) 31-1140.10U/ fk /'���/ (Phone)
,7(4'S - g(1 • 6 z5
(Address) 9(cas/Lft &�V(/ . / l L , to� 4CS k � , M/V swzd
TYPE OF WORK 0 New Construction ['Deck ['Porch ❑Re-Roofing ['Re-Siding ['Lower Level Finish 0 Fireplace
['Addition ['Alteration ['Utility Connection (� /^�y(��y�(_ 1
CODE: ❑I.R.C. ❑I.B.C. . Misc: g C-ER C:Pe f f WrILIZ14,5
Type of Construction: I II III IV V ABA(Q) OO
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ l l V• "------
Division: 1 2 3 4 5 (excluding land)
I hereby ca....- 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-, tion d erty an• at 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
oiciak'can r- ke p ;,Tor•just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
., 6Coosi 1 -7--// A '
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 lei. '75 Re ' t No.
Date Z, 2(o, l$ By ,
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 S.E.,Prior Lake,Minnesota 55372