HomeMy WebLinkAboutBuilding Permit 15. 0575 a op n
n n \ o a - 0 cOOO -0 o n
0 / R 22X/ s �z� �oQ z § %
m» c�c � m ■ m0
n n s r ■z m ■ m o
fp -4 1 ~ » k 2 k %KE§ § ® k�
& o n _■
•••
k �' n 0 •
m z O
2 ■
7 0 I. > z 2 0.
r0 mm
m J O o
% 7 0 0
J x 2mm O22000 11
2 $ Mr Imp
k 'V 3 \ • eco to ■
� _ m n
q 2 o 2 F-n 0 _a k 1. m
Q....,
?f,
a § 'I 1-1 2 2 ■ m \ o
; ,- -0-0 0 ' m
m . i
2 c n ■ .
0 .-
J O0000 '4 ...E\
o Q 11110§
k z 1-13-0ko , F.
> 2ga � 61 '1
ii -n ■ -4e
/ a? § 2
-1r o ®
of pR�o�P CITY OF PRIOR LAKE BUILDING PERMIT, v
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Date Recd
AND UTILITY CONNECTION PERMIT , ( e
��ANE9��P
(s----
I. white File PERMIT N
2. Pink City I NO./5 0�7�
(Please type or print and sign at bottom) 3 Yellow Applicant //
ADDRESS
I LI a-/-s --90(,,. .e. To i r1, - C 1 r ZONING(office use)
LEGAL DES RIPTION� ice use only)
LOT BLOCK ADDIS/• ,r
PID l,,s-- 04LQ-• /4/1--le,
OWNER ,`V
(Name) , OA CAA 14. 3O S Com{X (Phone) 95P- q90-0 aI
(Address)
BUILDER
(Company Name) 1(t&A pa 6, Z
(Phone) LOS f cQ l!—VU
(Contact Name) Q
(Address) '9a 0 CO , UGI( U S+ I� VJ l (Phone) L D(�,1 QtL f '7
i ��i �� 55 X13
TYPE OF WORK D New Construction ❑Deck
DAddition ❑Porch DRe-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fire lace
❑Utility Connection "_i VOL
OL� '3 A ^ ieNGtO u)p5 (11�
CODE: D.R.C. DI.B.C. sc. ` Illa /Oh "�i 1 .' W
Type of Construction: I II III IV V A B Q
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ 1 es i O9 '
Division: 1 2 3 4 5 (excluding land)
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-mewl' ed property and t 11 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 . oke this permit fo p ause. Furthermore,I hereby agree that the city official ora designee may enter upon the property to perform needed inspections.
Signature Contractor's License No.
Date
Permit Valuation
Park Support Fee # $
Permit Fee $
��� SAC # $
Plan Check Fee $ 7
1° Water Meter Size 5/8"; I"; $
State Surcharge $
;:av 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 $ -
TO,TAL DUE $ -/Ve7. ..c.----'1
This Application Becomes Your Building Permit When Approved " .�''a Al,• LReceipt No.
e/- 16---
Date ` � Com. By
(p /J 5�
4S
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
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,
issued. proceed as requested. Tansmustb document
a Certificate of Occupancy must be
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