HomeMy WebLinkAboutBuilding Permit 15. 0457 i0 0 n 000000 A o a ■ n
n n a 000 O _■ � 2 � 71 "n 0 § 0 ■q
k ri m m 7 s le,
_ P3 14 mo
R % 11 2 E Z ii 3BkB 8 ° E1
■
2 § ] . \ Z § 2
\ 0 / z> 2 m k
§ f r o
■ m
L. Z k 0 0 %
t 2 m r 2 000000 0
0 .4 3 0 0 ® � ca � IC2
z 0 x mzE
- R § m 0 -n 22 m § c)
m : _ zzzz - z ■ z z
0 z . r $ §§ % § p 0
\ Z / r- kk o m
I ■
E 0 '
§ <
2 E 2 XOOOOQ 11
a »
2 kkk�§ . �
t iE E � � �
4 g a � �M\k -j
"' MM ' d
Ct S ■
-1r o
Date Recd
4.of re10R CITY OF PRIOR LAKE BUILDING PERMIT, Dal /�
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
U t><f
I. venre File k Cny PERMIT NO. /5
��NNESO�� 3 Yellow Applicant
(Please type or print and sign at bottom) _ ZONING(office use)
ADDRESS i0 IN L
LEGAL DESCRIPTION(office use only)
PID
LOT BLOCK ADDITION
OWNER (Phone)
(Name)
(Address) /
BUILDER ,---, S �7
I •(Company Name) �_ ,�l
44_r (Phone)
�'; e1,,((w d (Phone)
(Contact Name) .� ,-1 -G
(Address) 1 1/'
fl1ttoniterationDUt0nnE0nDMisPROThCTCOST/VJ $ .
K 0 New Constr c n ❑Deck ❑Porch DRe-Roofing ORe-Siding ❑Lower Level Finish D Fireplace
❑AdditionAlteraionDUtonn nDMis
DI.B.ion: H III IV V ABPROJECTCOST/VUE $: A B E F H I M R S U (excluding land)
1 2 3 4 5
hat I
r
agent for the
I hereby- enmity dthat I have and that construe'on will application• ormto all xisting state and local laws and will proceed
est of my knowledge true in accordance certify
wi withsubmitted plan owner
I armtawarerthat the building
official
ut1-ficial can revoke this permit for it• cause. - nth ,I hereby agree that the city official or designee may enter u�e property to perform needed inspections./3��
x / C G3(ir s Date
Contractor's License No.
Signature
Park Support Fee # $
Permit Valuation 5°0_ 00 # $
$ SAC
Permit Fee �,�,v $
$ / Water Meter Size 5/8", 1";
Plan Check Fee `(�7. �
$ ' -7—Z.) Pressure Reducer
$
State Surcharge V
$ Sewer/Water Connection Fee #
$
Penalty # $
$ 5 Water Tower Fee
Plumbing Permit Fee Builder's Deposit $
Mechanical Permit Fee $ $
Sewer&Water Permit Fee $ Other
Gas Fireplace Permit Fee $ TOTAL DUE ' �/J//��
• ma.L
i arFrei.t No. kiljarAIIIIII
This Application Becomes Your Building Permit When Approved Dadte .r r Er pimmismillal
Buildine Official Date
This the
ning
ance
e is to certifybthe that the Plannerrconstitutes a temporary Certificatication and e of Zoning anying ocompliance ands is in allowsconstruct on to commence. Before occupancy,a Certificate requested.
Occt Occupancymustdocument
when signed by City
issued
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
DEPARTMENT OF
BUILDING AND INPRIOR LAKE
SPECTION
INSPECTION
RECORD
SITE ADDRESS / 5 fl' -Gd G✓ Gam► e
TYPE OF WORK 1l1/70t•to"....
USE OF BUILDING ,- r`S I /X.-
PERMIT NO. 4-5'7 DATE ISSUED /1, 15-j
BUILDER 662)/9126 & PHONE # 65/. ¢l7 6¢1
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
e� (i'9L' INSPECTOR DATE
*MN puidif%/4 ‘5/ I,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I RellOWIS INS e_dern qzc / ,
ZeM-A4c 6sett� /i.✓
FINAL I
FOR ALL INSPECTIONS (952) 447-9850