HomeMy WebLinkAboutBuilding Permit 15. 0365 J
w ot in
X Z _Z f.
►-
\'N � ZUVa W
2 w
�555Z < w
p �, I 0 LC CC et
U4. ti CC, I Z < •M
0000 ❑ ❑ '� w w
W 0
re N
J 2
0 N 'Z
0LU
< ii,
F=p OQ
_ / ZaZ - SSZZ y W
t
0 UJ
:W N0 O° temalaz 0 dU a xw
( Ill:LC U F-
a25 ( aLU
. I ,,, a fa HW —
Ili ILI X
111
0000 ❑ ❑ ! ww
OO
Q' Z
• a a LL =
n ~
UJ n 0 a < o w
U IV Z 0 Z IL �+
� 0 \ z F a
OZ p ZO W i-' - U of
a,O a Z H et A w
a� N z �z z W < 0
U.0V W W J YIL UJ J Q
OW z W = 00 N <F
y g 0 LLLL � = u) 0 3° o c°� 1.
U ? < 0 a 0000 C,) 0 0
CPRio� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT ¢' "r
NESDtP
I. while File PERMIT NO. I
3 PCity /� �7/ �'�
(Please type or print and sign at bottom) Yellow Applicant
�.•C!/��_LJa
ADDRESS
j 3/U 7y/A/! e..7-..
ZONING(office use)
kiso
LEGAL DESCRIPTION(office use only)
LOT /7 BLOCK 4 ADDITION BL61PP1' OF AJC WCUb 7M PID 2S, 4'59. 058-0
OWNER _ )
(Name) 4941�f�' S- tie /k... Cj'So2 .. /a i c7
(Phone)
(Address)
BUILDER
(Company Name) ..5fgNl5T (Phone)
(Contact Name)
(Phone)
(Address)
TYPE OF WORK D New Construction
erafiori eck ❑Porch DRe-Roofing Erne-Siding ❑Lower Level Finish ❑Fireplace
DAddition DUtility Connection
CODE: .R.C. ❑I.B.C. 0 Misc.
Type of C nstruction: I II III IV V A B
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have flirnished 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 revoke this perm r't cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X `Z—ail --1S---
Signature Contractor's License No.
Date
Permit Valuation 4 z_a a _0 0 Park Support Fee # $
Permit Fee $
4147s 7S--' SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1";
State Surcharge $
C. O 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 $
7 -ii.:7
This Applic on co v r Buildin' Permit -n App ved Paid ?1 J / ,�((
Re ipt No. �U
f Date 4- , _l B
Building Official ` ` rate
This is to certi hat the request i the above application and accompanying docume is is in ace rdance with the City Zoning Ordinance and may proceed as requested. This document
when signed b he ity ,nn - onstit tes a temporary Certificate of Zoning comp ante and lows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
IIW`
',;/! 4 LZ ICPlanni g : -. • Date
Special Conditions,if any
• • -. ice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
'''. .'' ''''':'.'. '. '''' ' '
P F� � R L°, �� " EDEPARTMENT
BULWNG A D�INSPECTIQN
INSPECTION, 5
_ ,..,..5
e� �+�ECORD, 5
y�
SITE ApDR�SS �(I�.9�� I��f7 .
TYPE OF WORK I . .
USE OF BUILDWG t,� �1.� /�"
PERMIT NO . ' +�7 DATE I �D # 22 ./S
BUILDER ���� . ,. �„ PHONE # tea. �/�*� �
NOTE: TWI$ IS N07 A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DTOR
I FOOTING 17. iw y,ry�,�.� ,�e.r DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
fFINAL I V I 7 /d,�6
FOR ALL INSPECTIONS (952) 447-9850