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HomeMy WebLinkAboutBuilding Permit 15. 0604 Ci 5" 0 tt:IX C) 000000 m 0 > EO k K � � � k ��k 0 © r � zBE �§ §� cn�R xi xi rn r > kz § § Z2 � 0 % © B P 0xl § m d e $ ou) Zz z0mo» § zq 0\ -r o 2 § al r o % m- o 73 73 z q RR c ❑ QO = O ("1, o \ § 1 ■ ■ E00 mr2 _1c■ co nc0 1 | § f% � § § z §■ m 0 n , -qm zzz§ - § § z � . m 2 0 0 rzxx - . c 0 Z ' m 1- §-0 P \ m / X 0 ���' X 0 § j ® m • O ❑ OHO § k Re \v mc ` (m § § % z _ zCC > \ » 2m -4C§ � k � � E C 6 i4 , © I OF PR/04. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd • TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / 0 AND UTILITY CONNECTION PERMIT C e_t:�, /S' K A'NESo11* 2.1. whitePink FlleCity PERMIT NO. 5v� - Ab y�. 3 Yellow Applicant / Ley (Please type or print and sign at bottom) ADDRESS Li I 35 � rl(�1���D ZONING(office use) U II sd-,se /sA LEGAL DESCRIQPTION(offic se only) '1 LOT BLOCF: ADDITI PID VD6' *-6 OWNERc/ - 6 (N(Name) -�)-` n( �SG�n co Vim. (Phone) Ur?.�' �� I 191 (Address) -11 (A Cera—b) 1 - SE - 191,-(s Uv' La—VA, ( 1 't k—) 3'- BUILDER i . i "r _ -- C (Company Name)l\� \NI ika,O1t= S±\J �' _- (Phone) air)-- s- -11- ( SA (Contact Name) Te C6-1 GL ���/t e� (Phone) LQ(�" �1 c'"( �l (Address) q? c) i}YL4 ( ;si, t. k(I c s4- ' (/�� 4 AU c 'lS TYPE OF WORK 0 New Construction DDecck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace DAddition ❑Alteration DUtility Connection 1 Fln ���yy isI.V w C.Q/{ ❑I. ty CODE: R.C. ❑I.B.C. l.t� c. t 1 Type of Construction: I H III IV V A B PROJECT COST/VALUE $ 'b000 Occupancy Group: A B E F HI MR SU (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 revo •this mit for just cause. Furth . ,I- •. agree that the city official or a designee may enter upon the property to perform needed inspections. tgnature i Contractor's License No. Date Permit Valuation /- Park Support Fee # $ Permit Fee $ 1.k 1%) # $ Plan Check Fee $ 1 ` Water Meter Size 5/8"; 1"; $ State Surcharge $ S iv _ 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 $ I tf, 7S This Application Becomes Your Building Permit When Approved pit''4 l qf Receipt No. it, 40 D. e 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, , i • Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850 4646 Dakota Street Prior Lake,MN 55372