HomeMy WebLinkAboutBuilding Permit 15. 0597 J o ❑ n O 0000 1 o > g
2 n g ) § moo 0 k co-
0
k / A k k k m E ; Eoz A e �m
r z n om ® Z .0 - ..4 P 2-
% t -I q 6 z
to ■ > ■ q Z z 0 73
� 70 0 . om mm
% 0N& ill N;
, g Zs
-I
% m Z poo • 000000
41 - mm � � � & � � r
t c2 c
/ f 200 � � 7 § � � in 0 2
% % e q �� > o 0 0 0 ■ - m
n S.') -n 0 z z z 0
k § lid > cc 0 §
I tst X 01 '
C i
< • 000000 o
m o11Mn §
R. t § k � ME ®
\ .k inn _
§ tm73 m4 _
§ m w - - c ■
� i 0
of PR10� CITY OF PRIOR LAKE BUILDING PERMITDate Recd
t. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
y'Ntves°tr I. White File PERMIT NO.
2. Pink City / -
3 Yellow Applicant [/. (//
(Please type or print and sign at bottom)
ADDRESS !'l( I ZONING(office use)
3 2-L-1,5 -F-d x T t L-- 0 v.)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) � -J-.\.1 G O ( /4 ` /q
(Phone) q S Z 4y 7` 1-
(Address) 31-4i 5 Fa)c r- ( IU 1.4.3 \PiLk 31e__
Livrz_�% ..44 AJs s 3-7-z—
BUILDER
(Company Name) iv\-��11kCy-k-.`'{- e-SL ,p (Phone) ?l03-3 /5 —07'1.5
(Contact Name) NAG ( J``�.1. a— <<S i.,,,--, ` (Phone) 2-V?f- `-1.2---k' irS t
(Address) IO 550 co fid- g-I S,k t e Zl O /1/(y I. t/<-1t4 iV S5.3 72--
TYPE OF WORK 0 New Construction ❑Deck ❑Porch ►'4 e-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace
['Addition ['Alteration ❑Utility Connection
CODE: L]I.R.C. ❑I.B.C. ❑Misc.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ 21/ 984- -
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-mentioned property and that all con ruction 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 rmit for just se Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Sig re Contractor's License No.
Date
Permit Valuation Park Support Fee # - $
Permit Fee $ 7 " [9 SAC ## $
Plan Check Fee $ / J Water Meter Size 5/8"; 1"; $
State Surcharge $ ---,, "N___,..,,7 ,....._____.—.Pressure Reducer $
Penalty $ .��r C Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ t
Builder's Deposit $
Sewer&Water Permit Fee $ `
Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved
Paid --2C1, 75. Receipt No �4' 071
Date 1p-Li -IS" B . Ijl a.
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
4646 Dakota Street Prior Lake,MN 55372