HomeMy WebLinkAboutBuilding Permit 15.0862 e"IN CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT /J Z '7/
41NN6s04t' I. White File PERMIT NO.
Pink2. City �� ��
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use) '
5O / �r»b�ac - bri vim, � � kms, ma) 5 70Z /'i D
LEGAL DESCRIPTION(office use only) /
LOT L BLOCK ADDITION �j/ p ) k` " ���� D R5-- Z/V—D4
OWNER ]� / r f
(Name) tie bliSia 1/ (Phone)s,07•07-- 7/9b
(Address)55P7b/k1C /I)e, Pio' /C&/C
BUILDER � c y
(Company Name) ilk Maiiiii4CZ (5��l !D (Phone) / 5/'�?36 ' /5
(Contact Name) ,'Y1 V (Phone)
(Address)di/45'/712)y-i7,0-4 , 4,4 SU//4} 12 ii X33?
TYPE OF WORK ❑New Construction (deck ['Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish El Fireplace
['Addition ['Alteration ❑Utility Connection
CODE: I.R.C. ❑I.B.C. ❑Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5 1
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
aboed 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
:ffitodt
it forju t cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
/ _ 41 , adZo8ia47 9-a7-/s
Signature Contractor's License No. Date
Permit Valuation oo_!'�� Park Support Fe-
Permit Fee $ / /g 7 SAC •
Plan Check Fee $
146-79354
• Water er 7 31 " po . • U4 011
State Surcharge $ ,% 0 0 Pressu' Redu : __
Penalty $ Sewer Water ( on -- - ..
•
Plumbing Permit Fee $ Water ower ' - =
Mechanical Permit Fee $ Builder' 'repo t
Sewer&Water Permit Fee $ Other
Gas Fireplace Permit Fee $ TOTAL DUE G
This A.7licati I Becomes Your Building Permit Whe Approv'd Paid *� (o-/ R.•-ipt No. ( 1b 1
Date I)
I II I 1 rl. # r f
`: ild a(AliciaDat i
This is to certify thai t e r:quest in the above application and accompanying documents i'in accor.ance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the 1 nner constttutes a temporary Certificate of Zoning complian.•and all( s construction to commence. Before occupancy,a Certificate of Occupancy must be
issued. / '
►ill\.... Z9
•arming Directo ;te Special Conditions,if any
24 hour notice for II insptetions(952)447-9850
4646 Dakota Street Prior Lake,MN 55372
RlOR LAKE
ANDDEPARTMENTBUILDING OFINSPECTIONS ENGINEERING
INSPECTION
RECORD
SITE ADDRESS 553/ "PlifiL&(VCO€2 d/
TYPE OF WORK D
USE OF BUILDING %2S 4/X-
PERMIT NO. 15'_. B6. 2- DATE ISSUED 7 Z-& 15-
BUILDER
rBUILDER 74 ,(2)R-2-7.A1 - 6,e-e-Ar PHONE # 657. 3,76, g6.4
61-x; 4.tsTT Foot, INSPECTOR DATE
I FOOTING
I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FINAL I I I
FOR ALL INSPECTIONS (952) 447-9850